Alcohol Withdrawal Seizures: Symptoms, Causes, Treatment, and More

Alcohol withdrawal syndrome can range in severity from mild to fatal, making it crucial for patients to present to care for evaluation of their symptoms. Patients who have had prior complicated withdrawals should not attempt to decrease their alcohol intake without consultation with their healthcare team. If a patient begins experiencing signs and symptoms of severe withdrawal, including but not limited to seizure, altered mental status, or agitation, they should seek emergency care immediately.

Alcohol Detox: Guidelines for Successfully Detoxifying from Alcohol

In the past, detox programs have used benzodiazepine to treat alcohol withdrawal and reduce the risk of seizures and hallucinations. However, gabapentin may be a non-addictive alternative that can be used in combination with other medications. While detoxing, clients who take gabapentin are also likely to experience improved mood, less anxiety, and better sleep quality. Alcohol consumption spans a spectrum ranging from low risk to severe alcohol use disorder (AUD). References for this review were identified by searches of PubMed between 1985 and 2016, and references from relevant articles.

Is Alcohol Dependence the Same as Alcoholism?

The periaqueductal gray is thought to trigger clonic seizures, whereas the pontine reticular formation is implicated in the generation of the tonic phase of audiogenic seizures (18). Some evidence suggests that the IC plays a role in alcohol withdrawal seizures in humans, as it does in rodents. Thus, humans with alcohol withdrawal seizures exhibit abnormalities in auditory-evoked potentials that are not observed in other settings, including increased latency to wave V (19,20), whose major source is the IC (21).

alcohol withdrawal seizures

• Clients reside at the treatment center, where they also consume all meals, socialize, attend therapy, and participate in rehabilitative activities.
• Symptoms outside of the anticipated withdrawal period or resumption of alcohol use also warrants referral to an addiction specialist or inpatient treatment program.
• Alcohol withdrawal seizures can occur within a few hours or up to 72 hours after stopping drinking.
• If untreated or inadequately treated, withdrawal can progress to generalized tonic-clonic seizures, delirium tremens, and death.

This system encourages you to repeat important activities, such as eating. This part of your brain works with feel-good chemicals like dopamine, which are responsible for rewarding, pleasurable feelings. When GABA comes to bind to the nerve cell, it opens up a channel to a negative charge that slows down brain activity. Alcohol alcohol withdrawal seizure and other central nervous system depressants keep that channel open, causing more intense sedating effects. Alcohol works in the brain by influencing a chemical called GABA, or gamma-Aminobutyric acid. GABA is a neurotransmitter responsible for slowing down activity in your brain so you can sleep, relax, and release stress.

Supporting Long-Term Abstinence

If you consistently consume significant amounts of alcohol, your CNS gets used to this effect. Your CNS must work harder to overcome the depressant effects of alcohol to keep your body functioning. According to the Epilepsy Society, consuming alcohol may make your epileptic medications less effective and may make the side effects of your medications worse. Alcohol is a diuretic, which means that it promotes water loss by increasing urine output. SUDEP is the sudden and unexpected death of a person with epilepsy who is otherwise healthy without a known cause.

• Mild symptoms may progress to alcohol hallucinosis, characterized by visual or auditory hallucinations that usually subside within 48 hours after alcohol cessation.
• Neurons within the deep layers of the superior colliculus (16) and the periaqueductal gray (17) also may play a role in the initiation of audiogenic seizures.
• Alcohol abuse can affect every area of an individual’s personal and professional life.
• There is a large degree of variability in alcohol metabolism as a result of both genetic and environmental factors.
• While the reason for this is not fully understood, alcohol does create changes in receptors in your brain that affect your likelihood of having a seizure.

WHAT WE TREAT

Benzodiazepines are first-line therapy for moderate to severe symptoms, with carbamazepine and gabapentin as potential adjunctive or alternative therapies. Physicians should monitor outpatients with alcohol withdrawal syndrome daily for up to five days after their last drink to verify symptom improvement and to evaluate the need for additional treatment. Primary care physicians should offer to initiate long-term treatment for alcohol use disorder, including pharmacotherapy, in addition to withdrawal management.

SESA syndrome (subacute encephalopathy with seizures in alcoholics)

Update on the Neurobiology of Alcohol Withdrawal Seizures