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Delirium tremens is a severe form of alcohol withdrawal characterized by a range of psychological and physiological symptoms. Tremors, delusions, and visual hallucinations are all commonly associated with this condition.

Tremors, or shaking, are often one of the first signs of withdrawal and can escalate in severity. Delusions can manifest as an altered perception of reality that results from the disruption in brain functioning due to alcohol withdrawal. Visual hallucinations, which involve seeing things that are not present, frequently occur during delirium tremens as well, further indicating the profound effect alcohol has on the nervous system during withdrawal.

While paranoia, which is characterized by intense and irrational mistrust or suspicion, may occur in various mental health conditions, it is not a hallmark symptom of delirium tremens. Instead, paranoia would more likely be a manifestation of underlying anxiety or a different psychiatric disorder, not specifically tied to the acute withdrawal state of delirium tremens. Therefore, it is correct to identify paranoia as a symptom that is not typically associated with delirium tremens.