Quantitative electroencephalographic analysis of delirium tremens development following alcohol‐withdrawal seizure based on a small number of male cases

Introduction Seizures and delirium tremens (DTs) are recognized as severe alcohol‐withdrawal symptoms. Prolonged admission and serious complications associated with alcohol withdrawal are responsible for increased costs and use of medical and social resources. This study investigated the predictive value of quantitative electroencephalography (QEEG) for developing alcohol‐related DTs after alcohol‐withdrawal seizure (AWS). Methods We compared differences in QEEG in patients after AWS (n = 13). QEEG was performed in the intensive care unit within 48 h of admission, including in age‐ and sex‐matched healthy controls. We also investigated the prognostic value of QEEG for the development of alcohol DTs after AWS in a retrospective, case‒control study. The spectral power of each band frequency and the ratio of the theta to alpha band (TAR) in the electroencephalogram were analyzed using iSyncBrain® (iMediSync, Inc., Korea). Results The beta frequency and the alpha frequency band power were significantly higher and lower, respectively, in patients than in age‐ and sex‐matched healthy controls. In AWS patients with DTs, the relative beta‐3 power was lower, particularly in the left frontal area, and the TAR was significantly higher in the central channel than in those without DTs. Conclusion Quantitative EEG showed neuronal excitability and decreased cognitive activities characteristic of AWS associated with alcohol‐withdrawal state, and we demonstrated that quantitative EEG might be a helpful tool for detecting patients at a high risk of developing DTs during an alcohol‐dependence period. Considering the complications related to alcohol withdrawal syndrome (AWS) such as seizure, delirium tremens and cardiac arrhythmia, it is important to identify the risk of delirium tremens (DT) following AWS and enhance preventive strategies. We observed the characteristics of quantitative electroencephalography in patients with AWS, specifically who developed DT.