Alcohol withdrawal is caused by the abrupt cessation of alcohol consumption in patients with alcohol dependence or chronic alcoholism.
The clinical presentation consists of a spectrum of signs and symptoms, including autonomic hyperactivity, tremulousness, restlessness, through to seizures and potentially life-threatening delirium tremens.
Alcohol withdrawal syndrome is a clinical diagnosis.
Symptom-triggered therapy with benzodiazepines remains the cornerstone of management.
Alcohol withdrawal syndrome (AWS), commonly referred to as 'the shakes', occurs in patients with alcohol dependence when their daily alcohol consumption is decreased or stopped. The decrease in blood ethanol below the level at which the patient is habituated triggers AWS. The syndrome typically begins within 4 to 12 hours after the patient's last drink, and may progress to potentially fatal delirium tremens.  
Interim Medical Director of Maryland Poison Center
Department of Emergency Medicine
University of Maryland School of Medicine
HK declares that he has no competing interests.
Division of Emergency Medicine
Medical University of South Carolina
NJC declares that he has no competing interests.
International Emergency Medicine
Long Island Jewish Hospital
KS declares that he has no competing interests.
Royal Prince Alfred Hospital and Discipline of Medicine
The University of Sydney
PSH is an author of a reference cited in this monograph.
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