What is Alcohol-Induced Seizure: Causes, Symptoms, Treatment, Pathophysiology, Prevention

Alcohol, as known to all, has varied health effects. A regular consumption of alcohol beyond the limits can affect the overall health and can also lead to life-threatening outcomes like liver and kidney damage and failure. It can also cause cardiovascular diseases. On consumption of alcohol, several mechanisms that control the activity of the brain also gets affected which in turn prolong the effect of intoxication and gradually the brain adapts to the alteration in these mechanisms. Similarly, when the alcohol intake is stopped the adaptive effects pass by, resulting in increased probability of various health issues. Alcohol-induced seizure is one such condition that can be triggered due to excessive consumption of alcohol.

Alcohol-induced seizure arise when alcohol consumption happens in excess and at an increased rates and then suddenly withdrawn from the practice. Alcohol-induced seizure tend to occur twelve to forty eight hours after withdrawal from alcohol but in some cases refraining from alcohol even for two hours may result in alcohol-induced seizures. Alcohol-induced seizure is common in individuals who have been alcoholic for a long time. There can be a single incidence or a brief spell of alcohol-induced seizures in a given period.

The common symptoms of alcohol-induced seizures are:

• Elevated heart rate
• Nausea
• Hallucinations
• Anxiety
• Tremors in hands
• Vomiting
• Headache
• Insomnia
• Irritability.

The prime cause of alcohol-induced seizure is continuous drinking for a long period of time which hampers and disrupts the neurotransmitters. Prolonged drinking when followed by sudden withdrawal may result in hyper-excitability of brain which results in irritability, agitation, tremors and alcohol-induced seizure.

The severity of symptoms post the withdrawal of alcohol is due to the fact that the alcohol acts as a central nervous depressant. The presence of alcohol within the body generates adaptive behaviors which are:

• Enhanced Activity of GABA: GABA or gamma aminobutyric acid is a neurotransmitter which has an inhibitory behavior. When alcohol is present within the body, it makes the body insensitive to the effect of GABA, thus more levels of amino acid are produced within the body to maintain the inhibitory activity. Progressively when the alcohol tolerance develops, individual requires more concentration of alcohol to have the desired arousal effect which in normal cases produces lethargy, exhaustion or coma in an individual. When the alcohol consumption is ceased the inhibitory activity of GABA is restored to normal against the adaptive behavior of the brain.
• Reduced Activity of Excitatory Amino Acids: The excitatory amino acids, like glutamate, which binds with N-methyl-D-aspartate (NMDA) receptor, results in a calcium influx which in turn leads to neuronal excitation. On consumption of alcohol the activity of glutamate is inhibited and increased levels of glutamate are secreted to achieve the normal state of arousal and also neuronal excitation. Thus, when there is a cessation in alcohol consumption, excessive unregulated excitation occurs.
• Preserving of Homeostasis: The continuous and prolonged presence of alcohol maintains homeostasis within the body.

This adaptive behavior is hindered due to sudden cessation of alcohol consumption which results in over activity of the brain and central nervous system leading to seizure.

Seizures can be defined as a sudden rush of electrical activity within the brain due to the occurrence of complex chemical changes in the neurons as a result of the onset of either excitatory or inhibitory impulses. This results in over activity or low activity of brain which causes an imbalance of excitatory and inhibitory activity within the central nervous system. The seizures are not a disease but mark the presence of different medical condition which primarily affects the brain. The seizures are classified as generalized tonic-clonic which is marked by unconsciousness, convulsions and muscle rigidity; absence seizures in which brief loss of consciousness occurs; Myoclonic seizures which involves isolated and jerking movements; Clonic seizures with repetitive and jerking movements; Tonic seizures in which muscle stiffness and rigidity occurs and lastly, Atonic seizures in which loss of muscle tone occurs. The alcohol induced seizures on the other hand is a seizure disorder which shows up the symptoms of generalized tonic-clonic seizures that arise due to a long history of prolonged alcoholism.

The presence of alcohol withdrawal syndrome and seizures is diagnosed through complete analysis of medical history, alcohol consumption, history of alcoholism and the total span of alcohol withdrawal. The diagnosis also includes checking for alternate drug abuse, if done. The diagnostic procedure involves below analysis:

• Physical Examination: A physical examination is conducted to identify the associated symptoms or any other complications such as arrhythmia, liver disease, gastrointestinal bleeding, pancreatitis, impaired nervous system and heart disease.
• Blood Test: The blood is checked for complete count of blood cells as well as levels of alcohol and electrolytes within the blood.
• Urine Test: It is specifically conducted to determine alcohol and the drug use.

The treatment of alcohol withdrawal syndrome depends on the severity of the conditions. In case the symptoms are mild then outpatient treatment is suited for an individual with alcohol-induced seizure. The outpatient treatment for alcohol-induced seizure requires the support of the close family members and friends to ensure safe detoxification of the patient. When the patient is pregnant or suffers from chronic alcoholism or has no reliable support from family and friends then inpatient treatment is opted. In case of inpatient treatment for alcohol-induced seizure, the focus relies on three rules which are:

• Reducing the immediate symptoms that appear.
• Preventing the chances of any complications.
• Promote abstinence from alcohol through therapy.

There are several drugs to check the symptoms arising due to the alcohol withdrawal. These are:

• Benzodiazepines to Treat Alcohol-Induced Seizure: These control the anxiety, perplexity and shakiness due to withdrawal. These include Valium, Librium, Ativan and Serax.
• Antipsychotic Drug to Treat Alcohol-Induced Seizure: These drugs are prescribed along with the benzodiazepine to help in relieving of hallucinations, irritability and agitation.
• Beta-Blockers: These are prescribed to treat heart related symptoms due to withdrawal like elevated heart rate and blood pressure, etc. The medicines include Catapres and Dilantin.

The treatment on alcohol withdrawal and seizures does not address the underlying issue of alcohol addiction and abuse. Thus, outpatient treatments and interventions should be taken as therapeutic measures. These involve cognitive behavioral therapy, therapy sessions in rehabilitation centers and contingency management. These help in building strong will power for alcohol abstinence and successfully mingle within the society through behavior modification, motivational incentives and support services.

When the alcohol-induced seizure are triggered, then post the treatment there are two key rules to incorporate in lifestyle, to prevent the relapse. These are:

• Refraining from binge drinking
• Avoiding from alcohol abuse.

These help in preventing relapse of the condition including alcohol-induced seizure and thus prevent future withdrawal symptoms as well.

The alcohol-induced seizure that arise due to alcohol withdrawal are a consequence of abstinence from alcohol for a period of over six hours to seventy two hours for an individual with a past of chronic alcoholism. The continuous alcoholism induces altered brain chemistry which gets hampered on alcohol withdrawal and results in seizures. These conditions make the individual hyper-excited and agitated. Though there are medications to check on the symptoms that appear due to withdrawal but psychotherapy and the help and support from family and friends helps in recovery, relapse as well as refrainment from any future chapters of alcohol-induced seizure.

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