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Can Alcohol Trigger Seizures?

Alcohol is a central nervous system (CNS) depressant. This means that it can affect the brain and cause various side effects. For example, it can increase the seizure threshold (a person’s likelihood of experiencing a seizure). 

A typical alcohol-related seizure (otherwise known as a tonic-clonic seizure) will cause a person to fall to the floor and shake violently for less than 5 minutes. 

You may reasonably think that drinking alcohol directly causes seizures. However, real-life clinical practice does not show enough data to support that statement definitively. Seizures in alcohol-dependent individuals may occur because of other simultaneous causes, e.g., an infectious or cerebrovascular disease. 

However, multiple studies have shown that alcohol-related seizures often occur after a person stops chronic alcohol consumption suddenly. It is a rebound effect. This means that these symptoms appear when a person quits drinking and experiences withdrawal.  

Not everyone who goes through alcohol withdrawal will have seizures. On the other hand, some people may be genetically predisposed to these seizures and have an increased risk.   

Overall, alcohol-related seizures could happen when people are acutely intoxicated, stop drinking suddenly, or have not touched a drink for many months. 

What Does an Alcohol Seizure Look Like?

If you experience an alcohol-related seizure, you will most often fall to the floor and shake violently for a few minutes. The clinical term for this type of seizure is called a tonic-clonic seizure. 

You may also harm yourself unintentionally when you have an alcohol-related seizure. Because you cannot control your body, you may hit your head, bite your tongue, or lose control of your bladder (incontinence).  

Additionally, you may feel confused and irritated after a seizure before you get complete consciousness again.  

Alcohol-related seizures are more common among men than women in the US. A contributing factor may be that women are three to four times less frequently heavy drinkers than men. 

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What Causes Alcohol-Induced Seizures?

It is important to know that alcohol-induced seizures could happen for many reasons. However, you face a higher risk of developing these seizures if you have one of the following risk factors:

  • Being epileptic 
  • A history of withdrawal seizures
  • A history of multiple previous detoxifications 
  • Known to be highly dependent on alcohol recently 

Alcohol Withdrawal Seizures (Delirium Tremens)

Alcohol withdrawal seizures occur after a chronic drinker suddenly quits, approximately within 6 to 48 hours.

When an alcohol-dependent person stops drinking, alcohol withdrawal syndrome sets in. Individuals who chronically drink typically experience severe withdrawal. In these cases, delirium tremens (DTs) can develop. 

Delirium tremens is when the body undergoes severe and unexpected mental or nervous system changes. During this phase, seizures may also arise. 

The main characteristics of seizures associated with delirium tremens include:

  • Can occur as early as 48 hours after the last drink (and can last up to 5 days)
  • Often happens in those with a history of complications from alcohol withdrawal 
  • Generalized tonic-clonic seizures 

However, withdrawal symptoms that accompany delirium tremens do not need to be present while a person experiences a seizure.

Alcohol Intoxication (Excessive Alcohol Consumption)

Alcohol poisoning can lead to seizures. However, these seizures may not be a result of the alcohol intake itself. Instead, lower blood sugar or head trauma caused by a sudden fall could be the underlying causes. 

Drinking to intoxication and binge drinking are not recommended. Current evidence supports that this type of drinking behavior can worsen seizures in such cases.

In 2019, 25.8% of people (18 and up) in the United States said they had participated in binge drinking within the last month. 

Mixing Alcohol and Epilepsy Drugs

Currently, there have not been enough clinical trials to show the efficacy and safety of antiepileptic drugs (AEDs) in people who are alcohol-dependent. 

However, there have been reports that the risk of seizure increases in an alcohol-dependent person who misuses a sedative and takes nonsedative AEDs. 

Overall, an alcohol-dependent person is recommended to seek care first for alcohol dependence before any drug treatment for non-withdrawal-related seizures. This approach minimizes the likelihood of drug use, drug intoxications, drug-alcohol interactions, and seizures. 

Alcohol and Epilepsy 

Drinking alcohol may trigger seizures in people with epilepsy. However, there has been debate about the relationship between alcohol consumption and seizures. 

A recent study showed that alcohol-related seizures were associated with heavy alcohol intake in one episode. Other factors that accompany excessive drinking and could increase the risk of seizures include:

  • Altered sleeping patterns 
  • Not adhering to antiepileptic medication 
  • Metabolic disturbances (or changes)

Researchers also found that people with generalized genetic epilepsy may be more susceptible to alcohol-related seizures. 

However, occasional or light/moderate alcohol consumption may not increase the risk of seizure occurrence in many patients with epilepsy. 

Because each person is unique, though, it is best to seek medical advice before having any alcoholic beverage. A doctor can assess whether light or moderate alcohol drinking is a safe activity.  

Approximately 41 to 49% of people with acute seizure issues (i.e., seizures that require emergency care and admission) in industrialized countries abuse alcohol. 

How Dangerous are Alcohol Seizures?

Alcohol seizures can be dangerous and even life-threatening. When you experience this type of seizure, you can hurt yourself by biting your tongue or hitting your head. You can even stop breathing. 

Also, if you have multiple alcohol withdrawal seizures, you could develop status epilepticus. This happens when:

  • a seizure occurs for more than 5 minutes
  • you have many seizures within 5 minutes without regaining a normal level of conscious 

In worst-case scenarios, status epilepticus may result in permanent brain damage, epileptogenesis (a condition in which the brain develops epilepsy), or death. 

Treatment for Alcohol Seizures

Doctors may consider three different approaches to treat alcohol seizures, including:

  • Treatment of seizures in progress
  • Preventive medication for seizures for those admitted for detoxification
  • Preventive medication for multiple seizures and status epilepticus after an acute alcohol withdrawal seizure episode   

Also, doctors may prescribe long-acting benzodiazepines or antiepileptics drugs alone to prevent seizures. Both are equally effective in treatment. 

In cases of possible delirium tremens, doctors may also recommend diazepam or clomethiazole (chlormethiazole). Both work well for preventing seizures and DT. 

Finally, for alcohol-dependent people with status epilepticus, doctors may administer phenytoin intravenously. 

Treatment for Alcohol Use & Addiction

If you or a loved one suffer from alcohol addiction, you have many different therapy options available:

  • Supervised detox or withdrawal process
  • Rehabilitation and support groups 
  • Inpatient and outpatient treatment facilities 
  • Counseling 
  • Medication-assisted treatment (MAT)

Medication-assisted treatment (MAT) has shown high potential in reducing alcohol use, and promoting cognitive-behavioral therapy (CBT) sessions could give those with the disorder better coping skills for triggers. Healthcare specialists may also prescribe medications like naltrexone, acamprosate, and disulfiram to treat the alcohol problem.

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Resources

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“Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, Feb. 2021, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics.

“Alcohol Related Seizures: Information for Patients, Relatives and Carers.” York Teaching Hospital NHS Foundation Trust, National Health System (NHS), Aug. 2020, www.yorkhospitals.nhs.uk/seecmsfile/?id=2857.

Hamerle, Michael, et al. “Alcohol Use and Alcohol-Related Seizures in Patients With Epilepsy.” Frontiers in Neurology, Frontiers , 15 May 2018, www.frontiersin.org/articles/10.3389/fneur.2018.00401/full.

Hillbom, Maria, et al. “Seizures in Alcohol-Dependent Patients: Epidemiology, Pathophysiology and Management.” CNS Drugs, U.S. National Library of Medicine, 2003, pubmed.ncbi.nlm.nih.gov/14594442/.

Rogawski, Michael A. “Update on the Neurobiology of Alcohol Withdrawal Seizures.” Epilepsy Currents, Blackwell Science Inc, 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC1312739/

“Treatment for Alcohol Problems: Finding and Getting Help.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#pub-toc3.

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