Question

All are true about delirium tremens except?

• A. Visual hallucinations
• B. Coarse tremors
• C. Third nerve palsy
• D. Confusion

Hint:

Eye-movement palsy in an alcoholic points to Wernicke, not to DT.

Answer 1

The Correct Option is C

Step 1: This is a negative-stem question. We must identify the feature that is NOT part of delirium tremens (DT), the most severe form of alcohol withdrawal.
Step 2: Delirium tremens typically begins 48 to 96 hours after the last drink and is characterised by clouding of consciousness with disorientation and confusion, prominent visual hallucinations (classically of small animals or insects), coarse tremors, marked autonomic overactivity (tachycardia, sweating, fever, hypertension), and agitation.
Step 3: Reviewing the options: Visual hallucinations, coarse tremors, and confusion are all classic and expected features of DT.
Step 4: Third nerve (oculomotor) palsy is NOT a feature of delirium tremens. Ophthalmoplegia in an alcoholic suggests Wernicke encephalopathy (thiamine deficiency) and characteristically involves the sixth (abducens) nerve causing lateral rectus palsy, not the third nerve as a DT feature. Hence Third nerve palsy is the exception.