alcohol-related seizures

Q: Status epilepticus is the hallmark of alcohol withdrawal seizures?

A) True

B) False

Answer: B

Status epilepticus in an alcoholic patient should lead a clinician to consider other etiologies. It is very unlikely to withdraw from alcohol with status epilepticus. Structural or infectious etiology should be ruled out.

The classic ETOH-associated withdrawal seizures occur within 12 to 48 hours as generalized tonic-clonic convulsions, but progress to status is unlikely.

Patient usually has a prolonged history of ETOH. It rarely occurs in young people. A typical patient is usually in their 40s or 50s. It usually occurs as a single event or a cluster of a few events within a short period - but rarely culminates into a status. 

#toxicology

#neurology

References:

1. Victor M, Brausch C. The role of abstinence in the genesis of alcoholic epilepsy. Epilepsia 1967; 8:1.

2. Rathlev NK, D'Onofrio G, Fish SS, et al. The lack of efficacy of phenytoin in the prevention of recurrent alcohol-related seizures. Ann Emerg Med 1994; 23:513.