26 Feb Alcohol Induced Epilepsy Seizures: Risks and Recommendations
When an individual consumes alcohol regularly, their brain and body adapt to its presence. The central nervous system adjusts to the depressant effects of alcohol by increasing activity in certain neurotransmitter systems to maintain balance. However, when alcohol is abruptly removed through sudden cessation or significant reduction in intake, the body’s equilibrium is disrupted, leading to a cascade of withdrawal symptoms, including seizures. These alcohol withdrawal seizures can occur within a few hours to several days after the last drink, depending on the individual’s drinking history and health factors. Alcohol withdrawal seizures are different from epilepsy seizures but can make epilepsy worse.
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Someone with delirium tremens may have hallucinations, psychosis, heartbeat changes and high body temperature. Seizures often occur during delirium tremens but are not always a symptom of this condition. Withdrawal seizures also happen independently of delirium tremens, and having seizures during withdrawal doesn’t necessarily mean that delirium tremens is present. Your risk of developing seizures seems to increase with an increasing amount of alcohol. Because of the risk of seizures and other serious symptoms, detoxing from alcohol should only be attempted with medical support.
Can Alcohol Withdrawal Cause Seizures?
- Seizures during withdrawal are often generalized tonic-clonic seizures, characterized by loss of consciousness, muscle stiffening, and convulsions.
- The question of whether alcohol triggers seizures is a critical concern, particularly for individuals with epilepsy or those predisposed to seizure disorders.
- Consulting with a healthcare professional or neurologist can provide personalized guidance on alcohol consumption, helping individuals make informed decisions to minimize the risk of seizures.
- This tailored advice is vital, as it considers the unique aspects of each person’s condition and medical history.
When alcohol intake is suddenly ceased, the brain, which has adapted to the constant presence of alcohol, enters a state of hyperexcitability. Chronic alcohol use suppresses glutamate and enhances GABA activity, creating a balance that the brain relies on. When alcohol is removed, this balance is disrupted, leading to excessive glutamate activity and insufficient GABA inhibition, resulting in neuronal hyperexcitability. Alcohol withdrawal seizures are a symptom of severe acute withdrawal syndrome and can be life-threatening, so they should be treated as a medical emergency.
- Compensatory upregulation of NMDA and kainate receptors (54) as well as calcium channels (55,56) also have been implicated in alcohol dependence and withdrawal seizures.
- However, other people with epilepsy find they can drink moderately without triggering a seizure.
- Our retrospective data collection on alcohol-related seizures also depended on subjects’ recall capability, and may reflect bias due to recall errors.
- While seizures can manifest in many ways, tonic-clonic seizures are the most common and can last up to two minutes.
Drug Detox and Withdrawal Symptoms
Seizures are a potential withdrawal symptom that can be prevented if you drink in moderation. Abnormally low blood sugar levels can lead to seizures, and this drop normally occurs at the same time as a hangover, causing people to connect the hangover with the seizure. Heavy alcohol use of three or more drinks in a day can also increase the frequency of seizures in those who already have epilepsy.
These observations have led to the view that alcohol withdrawal causes permanent epileptogenic changes in brain systems relevant to ethanol withdrawal seizures—a type of kindling phenomenon. Indeed, in accordance with the central role of the IC in triggering alcohol withdrawal seizures, multiple alcohol withdrawal episodes in rats facilitate the development of IC kindling (87,88). In animals, benzodiazepines have yielded variable effects, in some cases slowing withdrawal-induced kindling, and in other cases, causing paradoxical worsening (65,66,89). Whether other agents used in the treatment of alcohol withdrawal have antiepileptogenic potential remains to be determined. An alcohol withdrawal seizure is a serious complication that can occur when someone who has been drinking heavily for an extended period suddenly reduces or stops their alcohol intake.
Before a seizure, people may experience an aura or feel a change in sensation — such as smell, taste, sound, or vision — due to abnormal activity in the brain. Status epilepticus is a life threatening condition in which a person has a seizure lasting longer than 5 minutes without regaining normal consciousness or has more than one seizure within 5 minutes. Consuming alcohol in large quantities for extended periods seems to increase seizure frequency and might increase your risk of SUDEP. This article explores how alcohol affects people with epilepsy and provides recommendations for how much alcohol is best to consume. Alcohol consumption usually represents a taboo in the doctor-patient relationship and questions on the smoking status are answered more easily. Therefore, subjects were first queried about nicotine consumption and only later asked to give details on alcohol use.
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Alcohol withdrawal seizures are more likely to occur alcohol as a seizure trigger in those who have used alcohol heavily over prolonged periods. 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. When alcohol is consumed, it acts on the brain through several mechanisms that influence the seizure threshold.
Alcohol acts by stimulating receptors in your brain that cause brain activity to be suppressed. Alcohol itself does not normally cause seizures, but during withdrawal, when the suppressive activity of alcohol is removed, your brain will be more susceptible to seizures than it normally would. There are some specific considerations that may affect your risk of seizures when using alcohol. People with alcohol withdrawal seizures may also experience tremors, hallucinations, muscle spasms, and a rapid heart rate. Over half of those with alcohol withdrawal seizures may have repeat seizures, and up to 5% of cases may lead to status epilepticus. In some cases, excessive alcohol consumption may lead people to miss meals or medication, which can also make seizures more likely in people with epilepsy.
First, our data on alcohol use depended on patients’ self-reporting and may be affected by recall bias. It has been demonstrated that assessing alcohol consumption is biased by recall even when the recall period is only 1 week (25). Moreover, patients were seen at our institution at scheduled outpatient visits and did not attend the clinic after acute manifestations of alcohol-related seizures.
How Does Alcohol Affect Epilepsy?
These medications help restore the balance between inhibitory and excitatory neurotransmitters, reducing the risk of hyperexcitability and seizures. Gradual tapering of alcohol under medical guidance, rather than abrupt cessation, is often recommended to minimize the risk of withdrawal complications. Withdrawal seizures are a serious and potentially life-threatening complication of abruptly stopping alcohol consumption, particularly in individuals with a history of chronic or heavy drinking.
Additionally, alcohol withdrawal is a well-documented trigger for seizures, as the abrupt cessation of alcohol intake leads to a rebound in neuronal excitability due to the adaptive changes in neurotransmitter systems. This underscores the importance of understanding alcohol’s neurochemical effects when evaluating its role in seizure induction. In addition to that, alcohol intake significantly suppresses REM sleep periods (30).
Alcohol has the potential to enhance some side effects of anti-seizure medications, including drowsiness and dizziness. Do not mix anti-seizure medication and alcohol without first speaking to a physician. If someone has a seizure from alcohol withdrawal symptoms, you should move things out of the way that they could accidentally hurt themselves with during the seizure. You should also call 911 and get emergency medical help as soon as possible, even if the seizure has stopped.
Alcohol poisoning can increase the risk of seizures beyond what simply using too much alcohol would. Alcohol poisoning can severely reduce your blood sugar levels, leading to hypoglycemia. Hypoglycemia causes seizures and is more likely to occur in those who use medicine to keep their blood sugar levels in a normal range. Most of the time, because drinking enhances GABA’s effects, the brain is even more relaxed than normal. When the nervous system is overly depressed, it can lead to conditions that increase the likelihood of seizures when large amounts of alcohol are used.
A double-blinded, randomized, interventional study on 52 subjects with epilepsy demonstrated that a social alcohol intake over a 4-month-period did not increase seizure frequencies (2). In another interventional study on 14 patients with epilepsy and 10 healthy controls, acute moderate alcohol consumption initially suppressed epileptiform EEG-activity. Later however, when alcohol blood levels had declined, epileptiform EEG-activity was increased. Seizures occurred in some of those subjects and a rebound phenomenon was discussed (3). In this study, we aimed to systematically analyze alcohol drinking and the occurrence of alcohol-related seizures in 310 epilepsy patients.
Furthermore, we cannot exclude hypoglycemic episodes caused by acute heavy alcohol consumption (26), which may have contributed to the manifestation of epileptic seizures (27). In the study population, generalized genetic epilepsy was an independent predictor for the occurrence of alcohol-related seizures. The mean alcohol intake prior to alcohol-related seizures was not higher in patients with generalized genetic epilepsy than in subjects with focal epilepsy. Lennox stated that alcohol-related seizures had occurred more often in patients with symptomatic than in cryptogenic or idiopathic epilepsies (1). The then applied syndromatic allocation, however, may not be in exact conformance with the present classifications (16, 17).