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Alcohol And Seizures

Dr. Alan Weiner MD

Medically reviewed by

Dr. Alan Weiner, MD

February 11, 2019

Alcohol’s pleasant and euphoric effects are due to the way this drug impacts a user’s central nervous system (CNS). Despite the pleasant feelings, however, alcohol also has several negative consequences. The CNS can be detrimentally impacted from too much alcohol, leading to a host of neurological concerns and complications, such as an increased risk of seizure.

Despite its prevalence within the American social scene, alcohol is not as innocuous as some may think. Consumed responsibly, in moderate amounts, alcohol may be part of a balanced lifestyle. The risks attributed to alcohol consumption are not present for only those who suffer from an addiction, rather, a person who may drink in a manner they consider to be “social” may also find themselves affronted with numerous risks and dangers, including those to the brain, respiratory system, and digestive system.

Alcohol Abuse Sets The Stage For Seizures

The extent by which alcohol abuse is linked to seizures is significant, with one study abstract citing that “Alcohol abuse is a major precipitant of status epilepticus (9-25 percent of cases).” Status epilepticus is quite rare, however, it is very serious, with John Hopkins University telling us that it is “a seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes…This is a medical emergency that may lead to permanent brain damage or death.”

In order to help you understand the seizure risk that alcohol abuse poses, we have broken it down by specific factors or concerns. Though some entities consider an alcohol addiction separate from alcohol abuse, for the purpose of better informing you about the complete spectrum of alcohol-related seizure risks, we will include it here.

Binge Drinking, Not Just A Good Time

Binge drinking holds an unfortunate truth—far too many individuals partake in this damaging behavior, and consider it fairly without risk. A person may wrongly think that because they do not drink that often, that their drinking is not worrisome. A person may only drink once a week, however, if during these events they are binge drinking, they are in fact abusing alcohol and thusly endangering their health.

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as “a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours.” If you’re drinking within or above this range, then you are at risk.

Some individuals may experience an alcohol intolerance, which is akin almost to an allergy in the way it manifests itself—your body reacts severely and harshly to any alcohol consumption. Typically, this causes discomfort and other moderate symptoms, however, reports that in rare circumstances an individual suffering from this affliction may have a seizure due to their intolerance if they consume excessive amounts of alcohol.

One of the gravest dangers of binge drinking is alcohol poisoning. Alcohol poisoning occurs when a person consumes large quantities of alcohol so rapidly that their body’s detoxification systems cannot keep up with this influx. As this happens, alcohol begins to build up in the body, greatly overwhelming the central nervous system, and resulting in side effects, specifically, critical life-support systems malfunction or slow down.

During this period, a person may experience a seizure. It is theorized that these seizures may be partly related to the dehydration or low blood sugar (hypoglycemia) that results from binge drinking. Alcohol poisoning is very serious, a person in this state needs prompt medical attention and treatment.

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Alcohol Withdrawal Seizures

When a person has consumed alcohol compulsively and excessively for a prolonged period of time, they will encounter a set of withdrawal symptoms if they suddenly quit drinking without weaning themselves off alcohol. One of the most severe risks during this time is seizure. Seizure can in fact occur during two periods of detox, that of withdrawal seizures, and of delirium tremens (DTs). Not everyone experiencing withdrawal will progress to DTs.

During withdrawal seizures, also called “rum fits,” generalized tonic–clonic seizures (grand mal seizures) occur anywhere from six hours to two days after a person has stopped drinking. These seizures may present in an individual who has no prior history of seizure activity. Medscape tells us if people do not receive treatment, roughly 60 percent will experience more than one seizure, 3 percent will encounter the more severe status epilepticus, and 30-40 percent will continue to DTs.

Delirium tremens is the most serious form that withdrawal can take. It may appear in as little as three days, or it may be ten days before a person succumbs to its symptoms. DTs are most common in people who have a long history of drinking, while also having had experienced periods of withdrawal in the past. DTs can be extremely dangerous and even life-threatening. Seek medical support immediately if you have any doubt they are arising.

Despite the fact that other symptoms of DTs may take longer to manifest, DT seizures may develop in as little as 12 hours, and typically take the form of generalized tonic-clonic seizures. When a person has these seizures, they may first experience what is termed an aura. This is essentially a set of symptoms that preclude a seizure, including hallucinations, or those that affects a person’s sensory perception. Generalized tonic-clonic seizures exhibit the following symptoms, as listed by Medline Plus:

  • Rigid muscles
  • Convulsions
  • Clenching your teeth
  • Biting the inside of your mouth or tongue
  • Becoming unconscious
  • Blue-tinged skin
  • Incontinence (losing control of your bowels or bladder)

After a person has a seizure, they may experience mental fogginess, absence of memory during the incident, headache, a feeling of being intensely sleepy, or even temporary weakness of only one half of their body, termed Todd paralysis.

Medical Conditions May Influence This Risk

Individuals who have epilepsy should be especially concerned about this risk. The Epilepsy Foundation cautions that binge drinking may lead to status epilepticus for those who have epilepsy. Cleveland Clinic tells us that people with this condition may drink moderately without concern, however, those who drink to excess experience “lower seizure thresholds.” This is due to several factors, one being the fact that seizures are already linked to alcohol withdrawal.

Another factor is that certain anti-epileptic drugs are metabolized differently in the presence of alcohol, limiting their effectiveness. Events where excessive drinking is prominent commonly include later nights, leading to sleep deprivation, which may induce a seizure in a person with epilepsy. Lastly, persons with epilepsy may encounter a seizure when they withdrawal from binge drinking episodes.

Individuals who have a traumatic brain injury (TBI) (estimates suggest that 30-50 percent of these people experienced their injury while under the influence of alcohol) are more prone to seizures in general. Drinking increases that risk. A person with a TBI is altogether more sensitive to alcohol, also experiencing a decreased seizure threshold. For these reasons, it is strongly recommended that a person with TBI not drink.

Other Risks Of Alcohol-Related Seizure

In addition to the risk outlined above, there are various other circumstances involving alcohol consumption that may result in a seizure. Certain medications may react with alcohol to produce this effect. An example includes Chantix, a smoking cessation medicine; in early 2015, the FDA released a warning stating that persons using alcohol while on this medication have a rare chance of developing a seizure.

A more peripheral connection between alcohol abuse and seizures may be of concern for pregnant mothers and their future children. Though the findings are yet tentative and need more research to further support them, a Danish study found that if a mother consumes alcohol during a specific period of her pregnancy (11–16 gestational weeks), the child may have a 3.15 times greater chance of experiencing a neonatal seizure, as well as encountering a 1.81 times increase of developing epilepsy. It is worth noting, that researchers did not find any connection between seizures and binge drinking aside from this specific period of time.

Danger Of Seizures

In speaking of withdrawal seizures, there is a specific concern related to a person’s increased predisposition towards developing more seizures as time passes. This is referred to as the kindling phenomenon—every time a person undergoes withdrawal, their risk of seizure increases. An article, “Update on the Neurobiology of Alcohol Withdrawal Seizures” published in the journal Epilepsy Currents, explains what is a common perception of this occurrence, noting “that alcohol withdrawal causes permanent epileptogenic changes in brain systems relevant to ethanol withdrawal seizures.” The article continues to outline the severity of this situation, offering sobering news, “There is no recognized treatment to slow or prevent this kindling process.”

It remains to be seen if seizures can be deadly in terms of their direct effect. Scientific parties disagree on the particulars of this, both supporting that they can, and arguing that they cannot. What is certain, however, is that side effects from seizures can pose a risk of death. If a person seizes and vomits within the same period of time, their life may be jeopardized, as they are at risk of aspirating (breathing in) their vomit, or choking. Due to the uncontrollable and at times violent nature of seizure spasms and muscle contractions, a person may hit their head, causing extreme enough damage that a fatality could result.

Treating Seizures

In the context of withdrawal, other medical interventions to support detoxification will be administered, followed by treatments for alcohol addiction. If withdrawal is mild to moderate, outpatient treatment may in many cases be safe and sufficient, however, in more severe instances, we recommend that a person seek an intensive around-the-clock medical detox, which is in many cases available in an inpatient drug rehab.

In regards to the seizure itself, certain medical measures may be put in place, most notably certain benzodiazepines, including, as specified by American Family Physician, long-acting ones, such as Valium and Librium. Due to their longer half-life, “withdrawal is smoother, and rebound withdrawal symptoms are less likely to occur.” In other instances, especially, as they note if a person does not metabolize medications well, intermediate-acting versions may be utilized. Examples offered include Ativan and Serax. Lastly, they state that Dilantin may be useful adjunct medicine for those who have a pre-existing seizure condition.

Protect Yourself And Reach Out To Us

We want you to be healthy, body and mind, but we understand how hard it can be sometimes to get started on the right path. If you’re concerned about your binge drinking, or any other form of alcohol abuse and want to know more, can share some great resources with you. If your drinking has gotten out of control to the point where you have an addiction, we can offer you the encouragement and the direction that you need to find the alcohol treatment center that is the best fit for your life. Contact us now.

Epilepsy Foundation - Alcohol

Models Systems Knowledge Translation Center - Alcohol Use After A Traumatic Brain Injury

U.S. Food & Drug Administration - FDA Drug Safety Communication: FDA updates label for stop smoking drug Chantix (varenicline) to include potential alcohol interaction, rare risk of seizures, and studies of side effects on mood, behavior, or thinking

Medscape - Delirium Tremens (DTs) Clinical Presentation

MedlinePlus - Generalized tonic-clonic seizure

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