Skip to main content

Alcohol and Seizures

  • Chapter
Seizures

Abstract

Alcohol abuse is one of the most common causes of adult-onset seizures. Earnest and Yarnell reviewed 472 adults who were admitted with seizures and found that 41% were related to alcohol abuse (1). A variety of etiologies for seizures related to alcohol exist, the most frequent being the partial or absolute withdrawal of alcohol following a period of heavy use. In addition, seizures may be caused by acute head trauma or alcohol-related toxic-metabolic disorders. Other factors noted to precipitate seizures in the setting of acute and chronic alcohol abuse include pre-existing idiopathic or post-traumatic epilepsy. The term alcohol-related seizures (ARSs) has been adopted in recognition of the multifactorial origin of seizures in the setting of acute and chronic alcoholism (2). Today the management of patients presenting with ARSs remains challenging, despite years of experience, observation, and study.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ernest MP, Yarnell PR. Seizure admissions to a city hospital: the role of alcohol. Epilepsia 1976; 17: 387–393.

    Article  Google Scholar 

  2. Freedland ES, McMicken DB. Alcohol-related seizures, Part 1: pathophysiology, differential diagnosis, and evaluation. J Emerg Med 1993; 11: 463–473.

    Article  PubMed  CAS  Google Scholar 

  3. Hippocrates: Hippocrates, with an English translation by WHS Jones,4 vols. The Loeb Classical Library, 1923–1931.

    Google Scholar 

  4. Jellinek EM. Classics of the alcohol literature: Magnus Huss Alcoholismus chronicus. Q J Stud Alcohol 1943; 4: 85–92.

    Google Scholar 

  5. Victor M, Adams RD. The effect of alcohol on the nervous system. Res Publ Ass Nervment Dis 1953; 32: 526–573.

    CAS  Google Scholar 

  6. Isbell H. Fraser HF, Wilder A, et al. An experimental study of rum fits and delirium tremens. Q J Stud Alcohol 1955; 16: 1–33.

    PubMed  CAS  Google Scholar 

  7. Victor M, Brausch CC. The role of abstinence in the genesis of alcoholic epilepsy. Epilepsia 1967; 8: 1–20.

    Article  PubMed  CAS  Google Scholar 

  8. Morris JC, Victor M. Alcohol withdrawal seizures. Emerg Clin North Am 1987; 5: 827–839.

    CAS  Google Scholar 

  9. Hunt WA. The effect of ethanol on GABAergic transmission. Neurosci Biobehav Rev 1983; 7: 87–95.

    Article  PubMed  CAS  Google Scholar 

  10. Charness ME, Querimit LA, Henteleff M. Ethanol differentially regulates G proteins in neuronal cells. Biochem Biophys Res Commun 1988; 155: 138–143.

    Article  PubMed  CAS  Google Scholar 

  11. Greenberg DA, Darpenter CL, Messing RO. Ethanol-induced component of 45Ca2+ uptake in PC12 cells is sensitive to Ca2+ channel modulating drugs. Brain Res 1987; 410: 143–146.

    Article  PubMed  CAS  Google Scholar 

  12. Hillbom ME. Occurrence of cerebral seizures provoked by alcohol abuse. Epilepsia 1980; 21: 459–466.

    Article  PubMed  CAS  Google Scholar 

  13. Rathlev NK, Shieh T, Callum M. Etiology of alcohol withdrawal seizures and their occurrence in relation to decreased availability of alcohol. Ann Emerg Med 1992; 21: 663 (abstract).

    Article  Google Scholar 

  14. Hauser W, Ng S, Brust J. Alcohol, seizures and epilepsy. Epilepsia 1988; 29 (Suppl 2): 566–578.

    Article  Google Scholar 

  15. Marinacci A. A special type of temporal lobe (psychomotor) seizures following ingestion of alcohol. Bull L A Neurol Soc 1963; 27: 241–245.

    Google Scholar 

  16. Walder A, Redding J, Faillace L, and Steenberg RW. Rapid detoxification of the acute alcoholic with hemodialysis. Surgery 1969; 66: 201–207.

    PubMed  CAS  Google Scholar 

  17. Simon R. Alcohol and seizures. N Engl J Med 1988; 319: 715–716.

    Article  PubMed  CAS  Google Scholar 

  18. Victor M. The role of hypomagnesemia and respiratory alkalosis in the genesis of alcohol-withdrawal symptoms. Ann NYAcad Sci 1973; 215: 235–248.

    Article  CAS  Google Scholar 

  19. Wilson A, Vulcano B. A double-blind, placebo-controlled trial of magnesium sulfate in the ethanol withdrawal syndrome. Alcohol Clin Exp Res 1984; 8: 542–545.

    Article  PubMed  CAS  Google Scholar 

  20. Rathlev NK, D’Onofrio G, Fish SS, et al: The efficacy of phenytoin in the prevention or recurrent alcohol withdrawal seizures. Ann Emerg Med 1994; 23: 513–518.

    Article  PubMed  CAS  Google Scholar 

  21. D’Onofrio G, Rathlev NK, Ulrich AS, Fish SS, Freedland ES. Lorazepam for the prevention of recurrent seizures related to alcohol. N Engl J Med 1999; 340: 915–919.

    Article  PubMed  Google Scholar 

  22. Isslbacher K. Metabolic and hepatic effects of alcohol. N Engl J Med 1077; 296: 612–616.

    Google Scholar 

  23. Fitgerald FT. Hypoglycemia and accidental hypothermia in an alcoholic population. West J Med 1980; 113: 105–107.

    Google Scholar 

  24. Sucov A, Woolard RH Ethanol-associated hypoglycemia is uncommon Acad Emerg Med 1995; 2: 185–189.

    Article  PubMed  CAS  Google Scholar 

  25. Lambie DG, Stanway L, Johnson RH. Factors which influence the effectiveness of treatment of epilepsy. Aust NZ J Med 1986; 16: 779–784.

    CAS  Google Scholar 

  26. Lennox WG. Alcohol and epilepsy. Q J Stud Alcohol 1941; 2: 1–11.

    CAS  Google Scholar 

  27. Mattson RH, Sturman JK, Gronowski ML, Goico H. Effect of alcohol intake in nonalcoholic epileptics. Neurology 1975; 25: 361–362.

    Google Scholar 

  28. Hoppener RJ, Kuyer A, van der Lugt PJM. Epilepsy and alcohol: the influence of social alcohol intake on seizures and treatment in epilepsy. Epilepsia 1983; 24: 459–471.

    Article  PubMed  CAS  Google Scholar 

  29. Hillbom M, Kaste M, Rasi V. Can ethanol intoxication affect hemocoagulation to increase the risk of brain infarction in young adults? Neurology 1983; 33: 381–384.

    Article  PubMed  CAS  Google Scholar 

  30. Gill JS, Shipley MJ, Tsementzis SA, et al. Alcohol consumption-a risk factor for hemorrhagic and non-hemorrhagic stroke. Am J Med 1991; 90: 489–497.

    PubMed  CAS  Google Scholar 

  31. Weisber LA. Alcoholic intracerebral hemorrhage. Stroke 1988; 19: 1565–1569.

    Article  Google Scholar 

  32. Hillbom M, Kaste M. Alcohol intoxication: a risk for primary subarachnoid hemorrhage. Neurology 1982; 32: 706–711.

    Article  PubMed  CAS  Google Scholar 

  33. Hauser W, Hesdorffer D. Epilepsy: Frequency, Causes, and Consequences. New York: Demos, 1990.

    Google Scholar 

  34. Yamane H, Kiatoh N. Alcoholic epilepsy: a definition and a description of other convulsions related to alcoholism. Eur Neurol 1981; 20: 17–24.

    Article  PubMed  CAS  Google Scholar 

  35. Altura B, Gebrewold A. Alcohol-induced spasms of cerebral blood vessels: relation to cerebrovascular accidents and sudden death. Science 1983; 720: 331–333.

    Article  Google Scholar 

  36. Larkin E, Watson-Williams E. Alcohol and the blood. Med Clin North Am 1984; 68: 105–120.

    PubMed  CAS  Google Scholar 

  37. Annegers J, Grabow J, Groover RV, Laws ER Jr, Elveback LR, Kurland LT. Seizures after head trauma: a population study. Neurology 1980; 30: 683–689.

    Article  PubMed  CAS  Google Scholar 

  38. McMicken D, Freedland E, D’Onofrio G. Alcohol and trauma. Emerg Med Clin North Am 1993; 11: 225–239.

    PubMed  Google Scholar 

  39. Pfefferbaum A, Rosenbloom M, Crusan K, and Jernigan TL. Brain CT changes in alcoholics: effects of age and alcohol consumption. Alcoholism 1988; 12: 81–87.

    PubMed  CAS  Google Scholar 

  40. Ballenger JC, Post RM Kindling as a model for the alcohol withdrawal syndromes. Br J Psychiatry 1078; 133: 1–14.

    Article  Google Scholar 

  41. Brown ME, Anton RF, Malcolm R, Ballenger JC. Alcohol detoxification and withdrawal seizures: Clinical support for a kindling hypothesis. Biol Psychiatry 1988; 23: 507–514.

    Google Scholar 

  42. Linnoila M, Mefford I, Nutt D, and Adinoff. Alcohol withdrawal and noradrenergic function: NIH Conference. Ann Intern Med 1987; 107: 875–889.

    PubMed  CAS  Google Scholar 

  43. Rosenblood A. Emerging treatment options in the alcohol withdrawal syndrome. J Clin Psychiatry 1988: 49 (Suppl): 28–31.

    Google Scholar 

  44. Aminoff M, Simon R. Status epilepticus: causes, clinical features and consequences in 98 patients. Am J Med 1988; 68: 657–666.

    Google Scholar 

  45. Pilke A, Partinen M, Kovanen J. Status epileptiacus and alcohol abuse: an analysis of 82f status epileptiacus admissions. Acta Neurol Scand 1984; 70: 443–450.

    Article  PubMed  CAS  Google Scholar 

  46. Lowenstein DH, Alldredge BK. Status epilepticus. N Eng J Med 1998; 338: 970–977.

    Article  CAS  Google Scholar 

  47. Wason S, Lacouture PG, Lovejosy FH Jr. Single high-dose pyridoxine treatment for isoniazid overdose. JAMA 1981; 246: 1102–1104.

    Article  PubMed  CAS  Google Scholar 

  48. Earnest MP, Feldman H, Marx JA, Harris BS, Biletch M, Sullivan LP. Intracranial lesions shown by CT scans in 259 cases of first alcohol-related seizures. Neurology 1988; 38: 1561–1565.

    Article  PubMed  CAS  Google Scholar 

  49. Reims WR, Wippold FJ II, Erickson KK: Seizure patient selection for emergency computed tomography. Ann Emerg Med 1993; 22: 1298–1303.

    Article  Google Scholar 

  50. Deisenhammer E, Klingler D, Tragner H. Epileptic seizures in alcoholism and the diagnostic value of EEG after sleep deprivation. Epilepsia 1984; 25: 526–530.

    Article  PubMed  CAS  Google Scholar 

  51. Haddox VG, Bidder TG, Waldron LE, Derby P, and Achen SM. Chlorazepate use may prevent alcohol withdrawal convulsions. West J Med 1987; 146: 695–696.

    PubMed  CAS  Google Scholar 

  52. Devenyi P, Harrison ML. Prevention of alcohol withdrawal seizures with oral diazepam loading. Can Med Assoc J 1985; 132: 798–800.

    PubMed  CAS  Google Scholar 

  53. Marx JA, Berner J, Bar-Or D, et al. Prophylaxis of alcohol withdrawal seizures: a prospective study. Ann Emerg Med 1986; 15: 637 (abstract).

    Google Scholar 

  54. Browne TR, Penry JK. Benzodiazepines in the treatment of epilepsy: a review. Epilepsia 1973; 14: 277–310.

    Article  PubMed  CAS  Google Scholar 

  55. Young G, Rores C, Murphy C, Dailey RH. Intravenous phenobarb for alcohol withdrawal and convulsions. Ann Emerg Med 1987; 16: 847–850.

    Article  PubMed  CAS  Google Scholar 

  56. Rothstein E. Prevention of alcohol withdrawal seizures: the roles of diphenylhydantoin and chloridazepoxide. Am J Psychiatry 1973; 130: 1381–1382.

    PubMed  CAS  Google Scholar 

  57. Sampliner R, Iber FL. Diphenylhydantoin control of alcohol withdrawal seizures: results of a controlled study. JAMA 1974; 20: 1430–1432.

    Article  Google Scholar 

  58. Hillbom M, Tokola R, Kuusela V, et al. Prevention of alcohol withdrawal seizures with carbamazepine and valproic acid. Alcohol 1989; 6: 223–226.

    Article  PubMed  CAS  Google Scholar 

  59. Alldredge B, Lowenstein D, Simon R. Placebo-controlled trial of intravenous diphenylhydantoin for short-term treatment of alcohol withdrawal seizures. Am J Med 1989; 87: 645–648.

    Article  PubMed  CAS  Google Scholar 

  60. Chance J. Emergency department treatment of alcohol withdrawal seizures with phenytoin. Ann Emerg Med 1991; 20: 520–522.

    Article  PubMed  CAS  Google Scholar 

  61. Litten RZ, Allen JP. Pharmacotherapies for alcoholism: promising agents and clinical issues. Alcohol Clin Exp Res 1991; 15: 620–633.

    Article  PubMed  CAS  Google Scholar 

  62. Seller EM. Alcohol, barbiturate and benzodiazepine withdrawal syndromes: clinical management. Can Med Assoc J 1988; 139: 113–120.

    Google Scholar 

  63. Greenblatt DJ, Shader RI. Benzodiazepines in Clinical Practice. New York: Raven 1974.

    Google Scholar 

  64. Kaim SC, Klett CJ, Rothfeld B. Treatment of the cute alcohol withdrawal state: a comparison of four drugs. Am J Psychiatry 1969; 125: 1640–1646.

    PubMed  CAS  Google Scholar 

  65. Sellers EM, Naranjo CA, Harrison M, Devenyi P, Roach C, Sykora K. Diazepam loading: simplified treatment of alcohol withdrawal. Clin Pharmacol Ther 1983; 34: 822–826.

    Article  PubMed  CAS  Google Scholar 

  66. Naranjo CA, Sellers EM, Chater K, Iversen P, Roach C, Sykora K. Nonpharmacologic intervention in acute alcohol withdrawal. Clin Pharmacol Ther 1983; 34: 214–219.

    Article  PubMed  CAS  Google Scholar 

  67. Elliot HW, Nomof N, Navarro G, Ruelius HW, Knowles JA, Comer WH. Central nervous system and cardiovascular effects of lorazepam in man. Clin Pharmacol Ther 1971; 12: 468–481.

    Google Scholar 

  68. Greenblatt DJ, Shader RI. Prazepam and lorazepam, two new benzodiazepines. N Engl J Med 1978; 299: 1342–1344.

    Article  PubMed  CAS  Google Scholar 

  69. Miller WC Jr, McCurdy L. A double-blind comparison of the efficacy and safety of lorazepam and diazepam in the treatment of the acute alcohol withdrawal syndrome. Clin Ther 1984; 6: 364–371.

    PubMed  Google Scholar 

  70. O’Brien J, Meyer R, Thomas D. Double-blind comparison of lorazepam and diazepam in the treatment of the acute alcohol abstinence syndrome. Curr Ther Res 1983; 34: 825–831.

    Google Scholar 

  71. Brown TR. The pharmacokinetics of agents used to treat status epilepticus. Neurology 1990; 40 (Supp12): 28–32.

    Google Scholar 

  72. Hoyumpa AM Jr. Disposition and elimination of minor tranquilizers in the aged and in patients with liver disease. South Med J 1978;71(Supp12)23–28.

    Google Scholar 

  73. Kraus JW, Desmond PV, Marshall JP, Johnson RF, Schenker S, Wilkinson GR. Effects of aging and liver disease on disposition of lorazepam. Clin Pharmacol Ther 1978; 24: 411–419.

    PubMed  CAS  Google Scholar 

  74. Temkin NR, Dikmen SS, Wilesndky AJ, Keihm J, Chabal S, Winn HR. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med 1990; 323: 497–502.

    Article  PubMed  CAS  Google Scholar 

  75. Hauser WA, Ramirez-Lassepas M, Rosenstein R. Risk for seizures and epilepsy following cerebrovascular insults. Epilepsia 1984; 25: 666 (abstract).

    Google Scholar 

  76. Pinel JP. Alcohol withdrawal seizures: implications of kindling Pharmacol Biochem Behav 1980; 13 (Suppl 1): 225–231.

    Article  PubMed  Google Scholar 

  77. Hillbom M, Hjelm-Jager M. Should alcohol withdrawal seizures be treated with antiepileptic drugs? Acta Neurol Scand 1984; 69: 39–42.

    Article  PubMed  CAS  Google Scholar 

  78. Spencer SS, Spencer DD, Williamson PD, Mattson RH. Ictal effects of anticonvulsant medication withdrawal in epileptiac patients. Epilepsia 1981; 22: 297–307.

    Article  PubMed  CAS  Google Scholar 

  79. Bernstein E, Bernstein J, Levenson S. Project ASSERT: An ED-based intervention to increase access to primary care, preventive services and the substance abuse treatment system. Ann Emerg Med 1997; 30: 181–189.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

D’Onofrio, G., Ulrich, A.S., Rathlev, N.K. (2002). Alcohol and Seizures. In: Delanty, N. (eds) Seizures. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-094-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-094-0_10

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-207-0

  • Online ISBN: 978-1-59259-094-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics