Alcohol Abuse and Seizures: an Overview of Clinical Notions and Pathogenetic Theories

Gjon Preçi¹ and Gentian Vyshka^2,

¹Doctoral School, Faculty of Medical and Technical Sciences, University of Medicine in Tirana, Albania

²Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Albania

Cite this paper:
Gjon Preçi and Gentian Vyshka. Alcohol Abuse and Seizures: an Overview of Clinical Notions and Pathogenetic Theories. International Journal of Clinical and Experimental Neurology. 2014; 2(1):4-7. doi: 10.12691/ijcen-2-1-2

Abstract

Alcohol abuse is a major causative factor of different neurological disorders, among which seizures and epilepsy have an important burden of disease. Through discussing different pathogenetic mechanisms, scholars have tried to define and describe the diversity of clinical pictures and occurrences that might elicit a convulsive disorder in the alcoholics. An overview of the history of the diagnostic and classificatory attempts is made in the present paper, and distinctions between acute intoxication and withdrawal syndromes are summarized. The influences of ethanol on the cellular level and on the synaptic processes are succinctly mentioned. The authors are focused predominantly in three particularities of the alcohol-related seizures, namely the so-called alcoholic epilepsy, withdrawal seizures, and subacute encephalopathy with seizures in chronic alcoholism (SESA syndrome). Several sources are quoted, and the paper contains a brief overview on the efficacy of benzodiazepines and other antiepileptic drugs in the treatment of this variety of clinical events.

Keywords:
ethanol seizures epilepsy withdrawal syndrome chronic alcoholism

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Nikaj A, Vyshka G. A historical approach to alcohol abuse. International Journal of Clinical Toxicology. 2013; 1 (2): 52-55.
[2]	Rogawski MA. Update on the neurobiology of alcohol withdrawal seizures. Epilepsy Curr. 2005 Nov-Dec; 5 (6): 225-30.
[3]	Zorumski CF, Mennerick S, Izumi Y. Acute and chronic effects of ethanol on learning-related synaptic plasticity. Alcohol. 2014 Feb; 48 (1): 1-17.
[4]	Hendricson AW, Maldve RE, Salinas AG, Theile JW, Zhang TA, Diaz LM, Morrisett RA. Aberrant synaptic activation of N-methyl-D-aspartate receptors underlies ethanol withdrawal hyperexcitability. J Pharmacol Exp Ther. 2007 Apr; 321 (1): 60-72.
[5]	Echevarria MG. On alcoholic epilepsy. J Merit Sci 1881; 26: 489.
[6]	Victor M, Brausch C. The role of abstinence in the genesis of alcoholic epilepsy. Epilepsia. 1967 Mar; 8 (1): 1-20.
[7]	Devetag F, Mandich G, Zaiotti G, Toffolo GG. Alcoholic epilepsy: review of a series and proposed classification and etiopathogenesis. Ital J Neurol Sci. 1983 Sep; 4 (3): 275-84.
[8]	Weber M, Bouly S. Alcoolisme et épilepsie. La Lettre du Neurologue. 2002; 6 (4): 124-127.
[9]	Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS Jr, Swartz MN. Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med. 1993 Jan 7; 328 (1): 21-8.
[10]	Lennox W. Alcohol and Epilepsy. Q J Stud Alcohol. 1941; 2: 1-11.
[11]	Carrington CD, Ellinwood EH Jr, Krishnan RR. Effects of single and repeated alcohol withdrawal on kindling. Biol Psychiatry. 1984 Apr; 19 (4): 525-37.
[12]	Espir ML, Rose FC. Alcohol, seizures and epilepsy. J R Soc Med. 1987 Sep; 80 (9): 542-3.
[13]	Yamane H, Katoh N. Alcoholic epilepsy. A definition and a description of other convulsions related to alcoholism. Eur Neurol. 1981; 20 (1): 17-24.
[14]	Tartara A, Manni R, Mazzella G. Epileptic seizures and alcoholism. Clinical and pathogenetic aspects. Acta Neurol Belg. 1983 Mar-Apr; 83 (2): 88-94.
[15]	Bråthen G. The classification and clinical diagnosis of alcohol-related seizures. [Norwegian] Prisforedrag: Klassifikasjon og diagnostikk av alkoholrelaterte epileptiske anfall. Norsk Epilepsiselskaps høstmøte. NTNU. 2001.
[16]	Rathlev NK, Ulrich AS, Delanty N, D'Onofrio G. Alcohol-related seizures. J Emerg Med. 2006 Aug; 31(2): 157-63.
[17]	Hughes JR. Alcohol withdrawal seizures. Epilepsy Behav. 2009 Jun; 15 (2): 92-7.
[18]	Fisch BJ, Hauser WA, Brust JC, Gupta GS, Lubin R, Tawfik G, Hyacinthe JC. The EEG response to diffuse and patterned photic stimulation during acute untreated alcohol withdrawal. Neurology. 1989 Mar; 39 (3): 434-6.
[19]	Ropper AH, Brown RH. Adams and Victor’s Principles of Neurology. Eighth edition, McGraw-Hill, Medical Publishing Division. 2005; 1009-1010.
[20]	Rhinehart JW. Factors determining "rum fits". Am J Psychiatry. 1961 Sep; 118: 251-2.
[21]	Strande vom W. Chicago in tears and smiles. [Translated from German from Gutermann RE]. Cleveland, Ohio: Press of Lauer & Mattill. 1893; 37-38.
[22]	Andrew C, Fein G. Induced theta oscillations as biomarkers for alcoholism. Clin Neurophysiol. 2010 Mar; 121 (3): 350-8.
[23]	Niedermeyer E, Freund G, Krumholz A. Subacute encephalopathy with seizures in alcoholics: a clinical-electroencephalographic study. Clin Electroencephalogr. 1981 Jul; 12 (3): 113-29.
[24]	Janati A, Chesser MZ, Husain MM. Periodic lateralized epileptiform discharges (PLEDs): a possible role for metabolic factors in pathogenesis. Clin Electroencephalogr. 1986 Jan; 17 (1): 36-43.
[25]	Itoh N, Matsui N, Matsui S. Periodic lateralized epileptiform discharges in EEG during recovery from hyponatremia: a case report. Clin Electroencephalogr. 1994 Oct; 25 (4): 164-9.
[26]	Westmoreland BF. Periodic lateralized epileptiform discharges after evacuation of subdural hematomas. J Clin Neurophysiol. 2001 Jan; 18 (1): 20-4.
[27]	Boroojerdi B, Hungs M, Biniek R, Noth J. Subacute encephalopathy with epileptic seizures in a patient with chronic alcoholism (SESA syndrome). Nervenarzt. 1998 Feb; 69 (2): 162-5.
[28]	LaRoche SM, Shivdat-Nanhoe R. Subacute encephalopathy and seizures in alcoholics (SESA) presenting with non-convulsive status epilepticus. Seizure. 2011 Jul; 20 (6): 505-8.
[29]	Fernández-Torre JL, Kaplan PW. Subacute encephalopathy with seizures in alcoholics (SESA syndrome) revisited. Seizure. 2014 May; 23 (5): 393-6.
[30]	Schuchardt V. Der Alkoholiker als Intensivpatient – Erfahrungen einer Neurologischen Intensivstation. Intensivmed. 1988; 25: 55-62.
[31]	Leach JP, Mohanraj R, Borland W. Alcohol and drugs in epilepsy: pathophysiology, presentation, possibilities, and prevention. Epilepsia. 2012 Sep; 53 Suppl 4: 48-57.
[32]	Hillbom M, Pieninkeroinen I, Leone M. Seizures in alcohol-dependent patients: epidemiology, pathophysiology and management. CNS Drugs. 2003; 17 (14): 1013-30.
[33]	Bartolomei F. Epilepsy and alcohol. Epileptic Disord 2006; 8 (S1): S72-8.
[34]	Samokhvalov AV, Irving H, Mohapatra S, Rehm J. Alcohol consumption, unprovoked seizures, and epilepsy: a systematic review and meta-analysis. Epilepsia. 2010 Jul; 51 (7): 1177-84.
[35]	Gordon E, Devinsky O. Alcohol and marijuana: effects on epilepsy and use by patients with epilepsy. Epilepsia. 2001 Oct; 42 (10): 1266-72.
[36]	Lutz UC, Batra A, Kolb W, Machicao F, Maurer S, Köhnke MD. Methylenetetrahydrofolate reductase C677T-polymorphism and its association with alcohol withdrawal seizure. Alcohol Clin Exp Res. 2006 Dec; 30(12): 1966-71.
[37]	Soyka M, Schmidt P, Franz M, Barth T, de Groot M, Kienast T, Reinert T, Richter C, Sander G. Treatment of alcohol withdrawal syndrome with a combination of tiapride/carbamazepine: results of a pooled analysis in 540 patients. Eur Arch Psychiatry Clin Neurosci. 2006 Oct; 256 (7): 395-401.
[38]	Menken M, Buonpane N, Perly R. Alcoholic epilepsy. Effects of treatment on convulsions following the cessation of drinking. J Med Soc N J. 1977 Nov; 74 (11): 947-9.
[39]	Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013 Jul; 22 (2): 100-8.
[40]	DeMuro JP. Alcohol withdrawal syndromes in the critically ill. OA Alcohol 2013 Feb 01; 1 (1): 1.
[41]	Melson J, Kane M, Mooney R, McWilliams J, Horton T. Improving alcohol withdrawal outcomes in acute care. Perm J. 2014 Spring; 18 (2): e141-5.