Alcohol and Seizures

The relationship between alcohol use/abuse and degeneration of the brain is a contentious issue. Debates surrounding this topic continue. If you have epilepsy, consult your physician for more information on the approach to alcohol that is right for you.

There seems to be no increased risk for epilepsy in persons who drink less than 50 grams (about two drinks) of alcohol daily. Increasing daily alcohol consumption increases the risk for seizures. There is a 15- to 20-fold increase in risk of seizures for persons who drink 200 grams of alcohol or more on a daily basis.


Dangers of Consuming Alcohol


Studies(1) show that persons who regularly consume large amounts of alcohol can increase their risk of seizures by abruptly reducing or discontinuing consumption (withdrawal seizures). This drastic change in habit also increases the risk of developing epilepsy three-fold.

Based on surveys of volume and frequency of consumption, approximately 10 to 20 per cent of the adult population (over age 10) “drink heavily.” Approximately 10 per cent of this population will have seizures. Another 4.5 per cent of this population will be diagnosed with epilepsy by the age of 80.

Studies show between 10 and 25 per cent of newly diagnosed cases of epilepsy in adults specify chronic alcohol abuse as a risk factor. Withdrawal from alcohol consumption is a factor in about 30 per cent of persons experiencing alcohol-related seizures.(2)

Other risks associated with alcoholism

  • acquired post-traumatic epilepsy (from head injuries sustained in accidents),
  • meningitis,
  • neoplasms,
  • strokes,
  • hypoglycemia,
  • hyponatremia.
  • liver disorders,
  • pancreatitis,
  • depression,
  • chronic gastritis and
  • vitamin deficiency.

Alcohol and AEDs


Alcohol will increase the sedative effect of antiepileptic drugs (AEDs). AEDs may weaken a person’s tolerance to alcohol, making it easier to become intoxicated. Alcohol can alter a person’s rate of AED absorption and produce the following results:

  • Alcohol can reduce the effects of carbamazepine and phenobarbital.
  • Mixing alcohol with divalproex sodium causes severe depression of the central nervous system.
  • Alcohol will upset the blood serum level of phenytoin.
    • Acute alcohol intake will increase blood serum levels.
    • Chronic alcohol intake will decrease blood serum levels.

When excessive consumption of alcohol leads to missed medications (particularly if the omission is combined with inadequate sleep, irregular meals and emotional turmoil), seizures are almost certain to follow.


Alcohol and Driving


Alcohol abuse is the biggest risk factor causing road collisions and injuries, according to the Canadian Medical Association (CMA). Chronic alcohol abuse is a serious medical disability. A chronic alcohol abuser should not drive any type of motor vehicle.

The CMA suggests patients with alcohol dependence, including alcohol withdrawal seizures, should not be allowed to drive any type of motor vehicle. If a patient wishes to regain their licence, s/he must complete a recognized rehabilitation program for substance dependence and remain sober and and seizure free for 12 months.


References
1. SKC Ng, WA Hauser, JCM Brust & M Susser. Alcohol consumption and the risk of new onset seizures. New England Journal of Medicine. 1988; 319:666-673.
2. BS Koppel, M Daras, AJ Tuchman, WA Hauser, TA Pedley. The relation between alcohol and seizures in a city hospital population. Journal of Epilepsy. 1992; 5:31-37.

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