Seizure in ETOH withdrawal

Q: Seizure in alcohol withdrawal syndrome if left untreated can very quickly degenerate into status epilepticus?

A) True
B) False



Answer: B


Status epilepticus is not a feature of alcohol withdrawal-associated seizures. Actually, an astute clinician should quickly start investigating other associated etiologies common in this scenario such as central structural or infectious processes. Seizure in alcohol withdrawal syndrome is usually single or a brief flurry of seizures over a short period. If left untreated, one-third of seizures progress to delirium tremens (DT). Treatment is use of benzodiazepines, phenobarbital, or propofol. Phenytoin is ineffective. Carbamazepine and levetiracetam have been used but their efficacy is not established.

#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.