The diversity of alcohol-related seizures
Abstract number :
2.359
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2017
Submission ID :
349033
Source :
www.aesnet.org
Presentation date :
12/3/2017 3:07:12 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Christian Samsonsen, St. Olav's University Hospital, Trondheim, Norway; Harald Myklebust, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology; Tåle Strindler, Faculty of Medicine and Health Sciences, Norwegian Universit
Rationale: To investigate the relationship between alcohol and seizure disorders in acutely hospitalized patients. We wished to study the extent of the problem as well as the clinical characteristics of people with alcohol-related seizures, including their drinking patterns. Methods: In this prospective observational cross-over study a semi-structured interview took place after admission in 134 consecutive patients (epilepsy 92, isolated seizures 42). The Alcohol Use Disorders Identification Test (AUDIT) was applied. Daily alcohol consumption during the 5 days prior to the seizure as well as sleep-time during the last 3 days were recorded. A follow-up telephone interview (alcohol intake/sleep) covering the same weekday was performed on a seizure-free day at least 4 weeks later. Results: 28% of patients had AUDIT score greater than or equal to 8 (hazardous drinking); 22% in epilepsy, 43% in isolated seizures (p=0.012). Alcohol consumption and non-focal seizures were increased in isolated seizures not diagnosed as epilepsy, suggesting withdrawal. One in 5 patients with epilepsy had been binge drinking. In the 58 epilepsy patients with social drinking (excluded hazardous drinking/binging>12 units in one day), the alcohol intake was not different prior to seizure compared to follow-up, downgrading the role of modest alcohol intake as a seizure precipitant. However, 10 of 19 patients with idiopathic generalized epilepsy (IGE) had been binge drinking within two days prior to the seizure. Sleep loss before the seizure was associated with hazardous dinking. Conclusions: Alcohol is a major seizure precipitant in the context of hazardous drinking and withdrawal. Occasional social drinking ( < 2-3 units) in people with predominantly focal epilepsy is an uncommon cause of seizure breakthrough, but binge drinking prior to seizure admission in IGE is common. In people with epilepsy, alcohol intake is often combined with other seizure precipitants, e.g. sleep loss. Alcohol alone should not always be blamed. Funding: None.
Behavior/Neuropsychology