IMMUNOLOGICAL DIAGNOSTIC OF BLOOD CSF BARRIER IN THE COURSE OF DELIRIUM TREMENS

Fifty chronic alcoholics with acute withdrawal (in the state of delirium tremens) were examined initially and in the following weeks by quantitatively testing immunoglobulins in the serum and in the cerebrospinal fluid to study the dynamics of the blood-CSF barrier. Compared to other persons of the same age, acutely delirious patients show a pathologic IgG-IgA constellation in the CSF which does not depend on the serum. That points to an infrastructural barrier function disorder. After 2-4 weeks, delirium tremens, normally in the process of recovering, shows distinct sanitation of the immunologic spectrum of the CSF. With regard to their dynamic proceedings, the results confirm other findings on brain metabolism, biochemistry, neurophysiology, and pathologic anatomy during delirium tremens. The totally and progressively disturbed blood-CSF barrier system of complicated cases of delirium tremens (e.g., Korsakov's and Wernicke's syndromes) seems to provide the possibility of deterioration of the clinical syndrome. The method, simple to implement in the laboratory, permits not only an overall evaluation of the dynamic blood-CSF barrier function in acute and postdelirious state, but also provides both the possibility to diagnose a persistent infrastructural residual syndrome and to indicate a pathophysiologic complication of the clinical course. © 1979 Springer-Verlag.