During alcohol withdrawal, which event typically occurs 15-30 hours after quitting?

• A. Tremors, nausea, sweating, and vomiting
• B. Convulsive activity
• C. Delirium tremens lasting 3-4 days
• D. Insomnia only

Answer: (B)

Alcohol withdrawal unfolds in a progression as the brain readapts to the absence of a depressant. In the period roughly 15–30 hours after quitting, convulsive activity tends to appear because the brain shifts toward a hyperexcitable state once inhibitory control is reduced and excitatory activity increases without alcohol. This rebound in glutamatergic transmission paired with diminished GABAergic inhibition makes seizures a common event in this early window. Delirium tremens, by contrast, typically emerges later—about 2–3 days after the last drink—along with severe confusion, autonomic instability, and perceptual disturbances, so it wouldn't be expected in this 15–30 hour timeframe. While tremors, sweating, nausea, and vomiting can occur during withdrawal, the seizure activity is the hallmark feature most aligned with that 15–30 hour period.