Abstract
Purpose: This study aimed to assess alcohol consumption and the occurrence of alcohol-related seizures in patients with epilepsy within the last 12 months.Methods: In an epilepsy outpatient clinic, a standardized questionnaire was used to collect data retrospectively from consecutive adult epilepsy patients who had been suffering from the disease for at least 1 year. Logistic regression analyses were performed to identify independent predictors.Results: A total of 310 patients with epilepsy were included. Of these, 204 subjects (65.8%) consumed alcohol within the last 12 months. Independent predictors for alcohol use were antiepileptic drug monotherapy (OR 1.901) and physicians' advice that a light alcohol intake is harmless (OR 4.102). Seizure worsening related to alcohol consumption was reported by 37 of the 204 patients (18.1%) who had used alcohol. All 37 subjects had consumed large quantities of alcohol prior to the occurrence of alcohol-related seizures regardless of their usual alcohol-drinking behavior. The amount of alcohol intake prior to alcohol-related seizures was at least 7 standard drinks, which is equivalent to 1.4 L of beer or 0.7 L of wine. In 95% of cases, alcohol-related seizures occurred within 12 h after cessation of alcohol intake. Independent predictors for alcohol-related seizures were generalized genetic epilepsy (OR 5.792) and chronic heavier alcohol use (OR 8.955).Conclusions: Two-thirds of interviewed subjects had consumed alcohol within the last 12 months. This finding may be an underestimate due to patients' self-reporting and recall error. In all cases, the occurrence of alcohol related-seizures was associated with timely consumption of considerably large amounts of alcohol. Thus, a responsible alcohol intake seems to be safe for most patients with epilepsy. However, subjects with epilepsy and especially those with generalized genetic epilepsy should be made aware of an increased risk for seizures related to heavy alcohol consumption. Factors accompanying acute heavy alcohol intake such as altered sleep architecture, impaired adherence to antiepileptic medication, and metabolic disturbances may further facilitate the occurrence of seizures.
Highlights
Alcohol consumption may trigger seizures in patients with epilepsy
A single unprovoked seizure was defined as epilepsy if specific EEG alterations or causal brain lesions identified by magnetic resonance imaging (MRI) indicated an increased and enduring risk for further epileptic seizures [17]
Seven subjects had suffered from only one single unprovoked seizure: In four of these patients remote structural brain lesions were demonstrated by neuroimaging indicating focal epilepsy
Summary
Alcohol consumption may trigger seizures in patients with epilepsy. Yet, there is currently little knowledge on the alcohol-drinking behavior of epilepsy patients. Lennox comprehensively analyzed alcohol consumption and the occurrence of alcohol-related seizures in 1,254 subjects with epilepsy [1]. The occurrence of alcohol-related seizures was reported by 21.1% of subjects who had used alcohol, and was more often stated by patients with symptomatic than with idiopathic or cryptogenic epilepsy (as classified at that time). Apart from this, there is little research on the occurrence of alcohol-related seizures in patients with epilepsy. 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. Seizures occurred in some of those subjects and a rebound phenomenon was discussed [3]
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