Introduction
Patients sometimes present to the emergency department with seizures related to excessive alcohol use or illicit drug use. These seizures are usually acute symptomatic seizures resulting from substance withdrawal, direct toxic effects of the abused substance on the brain, or from indirect mechanisms, such as head trauma resulting from alcohol or substance abuse. This chapter reviews the mechanisms, clinical manifestations, and principles of management of alcohol-related seizures (ARS) and seizures related to drug abuse.
Alcohol Abuse and Dependence
The Diagnostic and Statistical Manual-IV (DSM-IV) defines alcohol abuse as a maladaptive pattern of alcohol use leading to clinically significant impairment or distress, as manifested by one or more of the following, occurring within a 12-month period:
- 1.
Recurrent alcohol use resulting in failure to fulfill major role obligations at work, school, or home.
- 2.
Recurrent alcohol use in situations in which it is physically...
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Alldredge BK, Lowenstein DH, Simon RP (1989) Seizures associated with recreational drug abuse. Neurology 39:1037–1039
Bird RD, Makela EH (1994) Alcohol withdrawal: what is the benzodiazepine of choice? Ann Pharmacother 28:67–71
Charnes ME, Roger PS, Greenberg DA (1989) Ethanol and the nervous system. N Engl J Med 321:442–452
Choy-Kwong M, Lipton RB (1989) Seizures in hospitalised cocaine users. Neurology 39:425–427
D’Onofrio G, Rathlev NK, Ulrich AS, Fish SS, Freedland ES (1999) Lorazepam for the prevention of recurrent seizures related to alcohol. N Engl J Med 340:915–919
Earnest MP, Yarnell PR (1976) Seizure admissions to a city hospital: the role of alcohol. Epilepsia 17:387–393
Freedland ES, McMicken DB (1993) Alcohol related seizures Part II: clinical presentation and management. J Emerg Med 11:605–618
Gill JS, Shipley MJ, Tsementzis SA (1991) Alcohol consumption-a risk factor for haemorrhagic and non-haemorrhagic stroke. Am J Med 90:489–497
Gold MS, Miller NS, Stennie K, Populla-Vardi C (1995) Epidemiology of benzodiazepine use and dependence. Psychiatr Annals 25:146–148
Harden CL, Montjo GE, Tuchman AJ, Daras M (1990) Seizures provoked by cocaine use. Ann Neurol 28:263–264
Herman ST (2002) Epilepsy after brain insult: targeting epileptogenesis. Neurology 59:S21–S26
Hillbom M, Kaste M (1982) Alcohol intoxication: a risk for primary subarachnoid haemorrhage. Neurology 32:706–711
Hillbom ME (1980) Occurrence of cerebral seizures provoked by alcohol abuse. Epilepsia 21:459–466
Kaiko RF, Foley K, Grabinski PY (1983) Central nervous system excitatory effects of meperidine in cancer patients. Ann Neurol 13:180–185
Kater RMH, Roggin G, Tobon F (1969) Increased rate of clearance of drugs from the circulation of alcoholics. Am J Med Sci 258:35–41
Kosten TR, O’Connor PG (2003) Management of drug and alcohol withdrawal. N Eng J Med 348:1786–1795
Mckeon A, Frye MA, Delanty N (2008) The alcohol withdrawal syndrome. J Neurol Neurosurg Psychiatr 79:854–862
Miller WC Jr, McCurdy L (1984) A double blind comparison of the efficacy and safety of lorazepam and diazepam in the treatment of the acute alcohol withdrawal syndrome. Clin Ther 6:364–371
Myers JA, Earnest MP (1984) Generalised seizures and cocaine abuse. Neurology 35:675–676
Ng S, Hauser WA (1988) Alcohol consumption and withdrawal in new onset seizures. N Engl J Med 319:666–673
O’Connor PG, Sammet JH, Stein MD (1994) Management of hospitalised intravenous drug users: role of the internist. Am J Med 96:551–558
Pascal-Leone A, Dhuna A, Altahfallah I, Anderson DC (1990) Cocaine-induced seizures. Neurology 40:404–407
Rathlev NK, D’Onofrio G, Fish SS et al. (1994) The lack of efficacy of phenytoin in the prevention of recurrent alcohol-related seizures. Ann Emerg Med 23:513–518
Rathlev NK, Ulrich AS, Delanty N, D’Onofrio G (2006) Alcohol-related seizures. J Emerg Med 31:157–163
Renganathan R, Delanty N (2003) Juvenile myoclonic epilepsy: under-appreciated and under-diagnosed. Postgrad Med J 79:78–80
Ritson B, Chick J (1986) Comparison of two benzodiazepines in the treatment of alcohol withdrawal: effects on symptoms and cognitive recovery. Drug Alcohol Depend 18:329–334
Shaw GK (1995) Detoxification: the use of benzodiazepines. Alcohol Alcoholism 30:765–770
Simon R (1988) Alcohol and seizures. N Engl J Med 319:715–716
Solomon J, Rouk LA, Koepke HH (1983) Double-blind comparison of lorazepam and chlordiazepoxide in the treatment of acute alcohol abstinence syndrome. Clin Ther 6:52–58
Weisber LA (1988) Alcoholic intracerebral haemorrhage. Stroke 19:1565–1569
Yamane H, Kiatoh N (1981) Alcoholic epilepsy: a definition and a description of other convulsions related to alcoholism. Eur Neurol 20:17–24
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer-Verlag London Limited
About this entry
Cite this entry
Chaila, E., Delanty, N. (2010). Alcohol and Illicit Drug Abuse Associated with Epileptic Seizures. In: Panayiotopoulos, C.P. (eds) Atlas of Epilepsies. Springer, London. https://doi.org/10.1007/978-1-84882-128-6_22
Download citation
DOI: https://doi.org/10.1007/978-1-84882-128-6_22
Publisher Name: Springer, London
Print ISBN: 978-1-84882-127-9
Online ISBN: 978-1-84882-128-6
eBook Packages: MedicineReference Module Medicine