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Seizure Risk With Recurrent Alcohol Detoxification

Seizure Risk With Recurrent Alcohol Detoxification Abstract • To determine if there is an increase in the risk of seizure activity when patients experience recurrent alcohol detoxifications, we reviewed the detoxification and seizure histories of 256 men and 45 women voluntarily admitted to a 5-day inpatient detoxification program. Structural brain damage, focal neurologic deficits, epileptogenic findings on electroencephalograms, and provocative drug use were all considered pertinent variables for seizure risk. Seizures did not occur during alcohol detoxification in any of the study patients, despite a high incidence of antecedent seizures and provocative drug use. Oral chlordiazepoxide use during detoxification was associated with the elimination of withdrawal seizures. Of all 301 patients, 64 had a history of seizures, 42 had significantly abnormal electroencephalograms during detoxification, and 30 had focal slowing on the electroencephalogram. There was no correlation between the duration of alcohol abuse or lifetime consumption of alcohol and seizure activity. There was, however, a significant correlation between the number of inpatient alcohol detoxifications and the prevalence of seizure disorders. This correlation held true even when provocative drug use was taken into consideration. References 1. Victor M, Adams RD. The effect of alcohol on the nervous system . Res Publ Assoc Nerv Ment Dis . 1953;35:526-573. 2. Isbell H, Fraser HF, Wikler A. An experimental study of the etiology of 'rum fits' and delirium tremens . Q J Stud Alcohol . 1955;16:1-33. 3. Hillbom ME. Occurrence of cerebral seizures provoked by alcohol abuse . Epilepsia . 1980;21:45-46.Crossref 4. Butler D, Messha FS. Alcohol withdrawal and carbamazepine . Alcohol . 1986;3:113-129.Crossref 5. Ng SKC, Hauser WA, Brust JCM, Susser M. Alcohol consumption and withdrawal in new-onset seizures . N Engl J Med . 1988;319:666-673.Crossref 6. Simon RP. Alcohol and seizures . N Engl J Med . 1988;319:714-715.Crossref 7. Brown ME, Anton RF, Malcolm R, Ballenger JC. Alcohol detoxification and withdrawal seizures: clinical support for a kindling hypothesis . Biol Psychiatry . 1988;23:507-514.Crossref 8. Hillbom ME, Hjelm-Jager M. Should alcohol withdrawal seizures be treated with antiepileptic drugs? Acta Neurol Scand . 1984;69:39-42.Crossref 9. Carrington CD, Ellinwood EH, Krishnan RR. Effects of single and repeated alcohol withdrawal on kindling . Biol Psychiatry . 1984;19:525-537. 10. Ballenger JC, Post RM. Kindling as a model for alcohol withdrawal syndromes . Br J Psychiatry . 1978;133:1-14.Crossref 11. Pinel JPJ. Alcohol withdrawal seizures: implications of kindling . Pharmacol Biochem Behav . 1980;13:225-231.Crossref 12. Alcohol Symposium Proceedings . Epilepsia . 1988;29:492-497.Crossref 13. Lechtenberg R. The Diagnosis and Treatment of Epilepsy . New York, NY: Macmillan Publishing Co Inc; 1984. 14. Moskowitz G, Chalmers TC, Sacks HS, Fegerstrom RM, Smith H Jr. Deficiencies of clinical trials of alcohol withdrawal . Alcoholism . 1983;7:42-46.Crossref 15. Drugs for Epilepsy . Med Lett Drugs Ther . 1989;31:1-4. 16. Savic I, Roland P, Sedvall G, Persson A, Pauli S, Widen L. In-vivo demonstration of reduced benzodiazepine receptor binding in human epileptic foci . Lancet . 1988;2:863-866.Crossref 17. Kaim SC, Klett CJ, Rothfeld B. Treatment of the acute alcohol withdrawal state: a comparison of four drugs . Am J Psychiatry . 1969;125:1640-1646. 18. Ulrichsen J, Clemmesen L, Flacks H, Hemmingsen R. The effects of phenobarbital and carbamazepine on the ethanol withdrawal reaction in the rat . Psychopharmacology . 1986;89:162-166.Crossref 19. Victor M, Brausch J. The role of abstinence in the genesis of alcoholic epilepsy . Epilepsia . 1967;8:1.Crossref 20. Begleiter H, Platz A. The effects of alcohol on the central nervous system in humans . In: Kissin B, Begleiter H, eds. The Biology of Alcoholism . Orlando, Fla: Plenum Press; 1971:293-343. 21. Chan AWK, Langan MC, Leong FW, Scharley DL, Penetrate ML. Does chronic ethanol intake confer full cross-tolerance to chlordiazepoxide? Pharmacol Biochem Behav . 1987;30:385-389.Crossref 22. Syapin PJ, Alkana RL. Chronic ethanol exposure increases peripheral-type benzodiazepine receptors in brain . Eur J Pharmacol . 1988;147:101-109.Crossref 23. Edelsberg JS. Alcohol consumption and withdrawal in new-onset seizures . N Engl J Med . 1989;320:596-597.Crossref 24. Maier DM, Pohorecky LA. The effect of repeated withdrawal episodes on subsequent withdrawal severity in ethanol-treated rats . Alcohol Depend . 1989;23:103-110.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Seizure Risk With Recurrent Alcohol Detoxification

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Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1990.00530050055012
Publisher site
See Article on Publisher Site

Abstract

Abstract • To determine if there is an increase in the risk of seizure activity when patients experience recurrent alcohol detoxifications, we reviewed the detoxification and seizure histories of 256 men and 45 women voluntarily admitted to a 5-day inpatient detoxification program. Structural brain damage, focal neurologic deficits, epileptogenic findings on electroencephalograms, and provocative drug use were all considered pertinent variables for seizure risk. Seizures did not occur during alcohol detoxification in any of the study patients, despite a high incidence of antecedent seizures and provocative drug use. Oral chlordiazepoxide use during detoxification was associated with the elimination of withdrawal seizures. Of all 301 patients, 64 had a history of seizures, 42 had significantly abnormal electroencephalograms during detoxification, and 30 had focal slowing on the electroencephalogram. There was no correlation between the duration of alcohol abuse or lifetime consumption of alcohol and seizure activity. There was, however, a significant correlation between the number of inpatient alcohol detoxifications and the prevalence of seizure disorders. This correlation held true even when provocative drug use was taken into consideration. References 1. Victor M, Adams RD. The effect of alcohol on the nervous system . Res Publ Assoc Nerv Ment Dis . 1953;35:526-573. 2. Isbell H, Fraser HF, Wikler A. An experimental study of the etiology of 'rum fits' and delirium tremens . Q J Stud Alcohol . 1955;16:1-33. 3. Hillbom ME. Occurrence of cerebral seizures provoked by alcohol abuse . Epilepsia . 1980;21:45-46.Crossref 4. Butler D, Messha FS. Alcohol withdrawal and carbamazepine . Alcohol . 1986;3:113-129.Crossref 5. Ng SKC, Hauser WA, Brust JCM, Susser M. Alcohol consumption and withdrawal in new-onset seizures . N Engl J Med . 1988;319:666-673.Crossref 6. Simon RP. Alcohol and seizures . N Engl J Med . 1988;319:714-715.Crossref 7. Brown ME, Anton RF, Malcolm R, Ballenger JC. Alcohol detoxification and withdrawal seizures: clinical support for a kindling hypothesis . Biol Psychiatry . 1988;23:507-514.Crossref 8. Hillbom ME, Hjelm-Jager M. Should alcohol withdrawal seizures be treated with antiepileptic drugs? Acta Neurol Scand . 1984;69:39-42.Crossref 9. Carrington CD, Ellinwood EH, Krishnan RR. Effects of single and repeated alcohol withdrawal on kindling . Biol Psychiatry . 1984;19:525-537. 10. Ballenger JC, Post RM. Kindling as a model for alcohol withdrawal syndromes . Br J Psychiatry . 1978;133:1-14.Crossref 11. Pinel JPJ. Alcohol withdrawal seizures: implications of kindling . Pharmacol Biochem Behav . 1980;13:225-231.Crossref 12. Alcohol Symposium Proceedings . Epilepsia . 1988;29:492-497.Crossref 13. Lechtenberg R. The Diagnosis and Treatment of Epilepsy . New York, NY: Macmillan Publishing Co Inc; 1984. 14. Moskowitz G, Chalmers TC, Sacks HS, Fegerstrom RM, Smith H Jr. Deficiencies of clinical trials of alcohol withdrawal . Alcoholism . 1983;7:42-46.Crossref 15. Drugs for Epilepsy . Med Lett Drugs Ther . 1989;31:1-4. 16. Savic I, Roland P, Sedvall G, Persson A, Pauli S, Widen L. In-vivo demonstration of reduced benzodiazepine receptor binding in human epileptic foci . Lancet . 1988;2:863-866.Crossref 17. Kaim SC, Klett CJ, Rothfeld B. Treatment of the acute alcohol withdrawal state: a comparison of four drugs . Am J Psychiatry . 1969;125:1640-1646. 18. Ulrichsen J, Clemmesen L, Flacks H, Hemmingsen R. The effects of phenobarbital and carbamazepine on the ethanol withdrawal reaction in the rat . Psychopharmacology . 1986;89:162-166.Crossref 19. Victor M, Brausch J. The role of abstinence in the genesis of alcoholic epilepsy . Epilepsia . 1967;8:1.Crossref 20. Begleiter H, Platz A. The effects of alcohol on the central nervous system in humans . In: Kissin B, Begleiter H, eds. The Biology of Alcoholism . Orlando, Fla: Plenum Press; 1971:293-343. 21. Chan AWK, Langan MC, Leong FW, Scharley DL, Penetrate ML. Does chronic ethanol intake confer full cross-tolerance to chlordiazepoxide? Pharmacol Biochem Behav . 1987;30:385-389.Crossref 22. Syapin PJ, Alkana RL. Chronic ethanol exposure increases peripheral-type benzodiazepine receptors in brain . Eur J Pharmacol . 1988;147:101-109.Crossref 23. Edelsberg JS. Alcohol consumption and withdrawal in new-onset seizures . N Engl J Med . 1989;320:596-597.Crossref 24. Maier DM, Pohorecky LA. The effect of repeated withdrawal episodes on subsequent withdrawal severity in ethanol-treated rats . Alcohol Depend . 1989;23:103-110.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: May 1, 1990

References