Clinical profile of patients with nascent alcohol related seizures

Those with an underlying health risk for seizures, a history of diabetes or who have experienced alcohol withdrawal seizures are most at risk. Most people who drink lightly or even moderately are at low risk of alcohol withdrawal seizures. These seizures are primarily generalized tonic-clonic seizures and can be single episodes or occur in a series. Our systematic data collection based on personal interviews allowed us to provide updated knowledge on the patterns of alcohol drinking and the occurrence of alcohol-related seizures in a large cohort of 310 epilepsy patients. In patients with generalized genetic epilepsy, seizures commonly manifest within 30 min after awakening.

• Study subjects passed through the domains of the questionnaire with an increasing social stigma degree.
• Consuming alcohol seems to aggravate seizures in people with epilepsy and may lead to increased seizure frequency.
• Among the IGE syndromes,17 IGE with GTCS is the one most likely to present to the clinician initially as ARS.
• Because alcohol is a depressant, it has a sedating effect on excitatory nerve cells and pathways.5 The results of neuron communication interference, or disruption, may include alcohol seizures.
• Heavy drinking, particularly withdrawal from heavy drinking, may trigger seizures in those with epilepsy.

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• If you aren’t sure how to help the person having a seizure, call 911 and follow the operator’s instructions.
• Lower blood sugar or head trauma caused by a sudden fall could be the underlying cause.
• For example, if you have experienced seizures, you may need to participate in inpatient detox supervised by medical professionals rather than detoxing in an outpatient setting.
• These medications can reduce the risk of seizures occurring and treat active seizures that do happen.
• These changes can promote seizure activity in people with and without epilepsy during periods of alcohol withdrawal.
• When people stop consuming alcohol after chronic use, they lose the inhibitory effects of the GABA receptors, resulting in the central nervous system being overstimulated.

The methodology of the current study was not geared to prove or disprove this assumption. It appears that the patients with new-onset epilepsy presenting to emergency or OPD were included even though the alcohol use may be an incidental or unrelated finding. Nearly 15 of 100 patients in the study did not have any withdrawal symptoms, indicating nondependent alcohol use. Out of 310 interviewed subjects, 204 (65.8%) had used alcohol within the last 12 months, 158 (51%) within the last 30 days, and 108 (34.8%) within the last 7 days.

Alcohol and Seizures: The Risks and How To Reduce Them

These changes can promote seizure activity in people with and without epilepsy during periods of alcohol withdrawal. People with a history of alcohol misuse seem to have a greater risk of developing sudden unexpected death in epilepsy (SUDEP) than people with epilepsy with no history. A 2017 review found that a history of alcohol misuse increased the risk of post-traumatic epilepsy in people with traumatic brain injury. Over half of those with alcohol withdrawal seizures may have repeat seizures, and up to 5% of cases may lead to status epilepticus. Alcohol-related seizures in those with epilepsy mostly occur due to alcohol withdrawal rather than the act of drinking itself. According to older research, alcohol consumption may have a causal relationship with seizures, and people who drink 200 g or more of alcohol daily may have up to a 20-fold increase in seizure risk.

General Health

In a 2022 review of 8 studies, researchers found that the risk of epilepsy was 1.7 times higher (95% confidence intervals from 1.16 to 2.49) in people who consumed alcohol compared to non-drinkers. Consuming alcohol seems to aggravate seizures in people with epilepsy and may lead to increased seizure frequency. Doctors often warn people who have epilepsy to avoid alcohol or to only drink in moderation. Heavy drinking, particularly withdrawal from heavy drinking, may trigger seizures in those with epilepsy. Alcohol may also affect anti-seizure medications, which could trigger seizures. An alcohol assessment will help determine if a person experiencing alcohol-related seizures need treatment for a possible alcohol use disorder.

These can be life-threatening episodes, so it’s critical to know what they look like and how they’re treated. In a 2020 study, research found that the risk of SUDEP was twice as high in people with a history of alcohol dependence or substance misuse disorder. Because of the risk of seizures and other serious symptoms, detoxing from alcohol should only be attempted with medical support. The researchers also found that the risk of epilepsy increased as alcohol consumption increased. According to the researchers, these results are consistent with previous studies. Seizures may occur in around 5% of people with alcohol withdrawal syndrome.

In people with epilepsy, drinking three or more drinks may increase the risk of seizures. Possible confounding variables that were included in the logistic regression model regarding the occurrence of alcohol-related seizures in patients with epilepsy within the last 12 months. The aim of this study is to characterize the clinical profile of patients with alcohol related seizures (ARS) and to identify the prevalence of idiopathic generalized epilepsy (IGE) in the same. For someone with a serious alcohol use disorder, withdrawal should only be attempted under the supervision of medical professionals who can intervene if complications arise. Often people going through withdrawal will be given a benzodiazepine to minimize the severity of symptoms and reduce the risk of brain hyperexcitability and subsequent seizure activity. Even in the 1960s, seizures during alcohol withdrawal were known as “rum fits.” The risk for seizures during withdrawal is correlated to the frequency and amount of alcohol consumed.

Associated Data

Alcohol withdrawal seizures are known to be recurrent, having occurred during the previous abstinent attempts. Whether such patients were included or not remains unclear from the available description. No objective test (e.g. urinalysis) was employed to rule out concurrent substance abuse, in particular, benzodiazepine use, which has the potential to induce withdrawal seizures similar to alcohol. It has been mentioned that all subjects gave informed written consent to participate in the study; however, some patients had delirium as reported in the paper. From an ethical perspective, a mention must be made of the consent from a legal guardian.

This article looks at the connection between alcohol, seizures, and epilepsy, as well as treatment options and support. The AUDIT, though used in the study, is an instrument meant to detect harmful or hazardous use (at cut-off score of 8) only. The scores over 20 on AUDIT may indicate possible dependence,3 but it is to be noted that AUDIT was also not employed as a screening tool, rather as an instrument for assessment. Further, it appears from the AUDIT score of sample 21.9 ± 4.86; Table 1 that at least a proportion of the patients scored below 20, and comprised of hazardous but alcohol related seizure non-dependent users. Your provider may recommend specific services based on your seizure history. For example, if you have experienced seizures, you may need to participate in inpatient detox supervised by medical professionals rather than detoxing in an outpatient setting.

Can alcohol trigger seizures?

Available evidence shows a strong and consistent association between duration of alcohol consumption and epilepsy. Patients with cortical atrophy had a significantly higher mean duration of alcohol intake compared to those who had no atrophy. In our series, 22% of patients had clustering of seizures in the current episode, out of which eighteen had cortical atrophy on CT scan of the brain. Evidence of cerebral atrophy in patients with ARS portends an increased risk for developing clustering.