Relationship between alcohol and seizures in a city hospital population

Abstract

Alcohol use can contribute to seizure occurrence, but the exact relationship is unclear. Possible mechanisms include alcohol neurotoxicity, withdrawal effects, interference with antiepileptic drug metabolism, and noncompliance with prescribed treatment. We studied the relationship between alcohol use and seizures in patients admitted to a city hospital or seen in its emergency room during a 1-year period. Nonalcohol users with seizures served as controls. Groups did not differ by age, history of head trauma, duration of seizures, or EEG findings. Alcohol users were more likely to be men, have subtherapeutic antiepileptic drug levels, and have abnormal computed tomography scans, especially diffuse atrophy. Among alcohol users, seizures were almost as likely to occur during acute intoxication as during withdrawal. Alcohol withdrawal as the only risk factor for seizures occurred in a minority of patients (30%). The relationship between alcohol and seizures is multifactorial and complex.