Table 1.

Clinical signs and symptoms distinguishing delirium tremens and hepatic encephalopathy

Symptoms/signs	Delirium tremens	Hepatic encephalopathy
Abstinence from alcohol	Constant relation	None
PMA	Increased	Akinetic with episodes of restlessness
Hallucinations	Visual, auditory, and tactile with unpleasant content Lilliputian hallucinations	Uncommon, simple elementary hallucinations of flashing lights, etc.
Affect	Anxiety/fear	Euphoric/depressed mood
Behavior	Over responsiveness to stimuli Occupational delirium	Desire not to be bothered No occupational delirium
Tremor	Fine to coarse, rhythmic	Flap tremor
Speech	Rapid and excited	Slow, slurred, and monotonous
Motor power	Not diminished	Initial: Diminished Later: Clasp-knife rigidity Coma: Flaccid
Posture	Tremulousness	Flexion attitudes
Sleep	Insomnia	Hypersomnia
EEG	Hyperactive, fast trace	Diffuse slowing
MRI	No specific changes	Bilateral, symmetric high signal intensity of the globus pallidus and substantia nigra

PMA – Para-methoxyamphetamine; EEG – Electroencephalography; MRI – Magnetic resonance imaging