Alcohol consumption, unprovoked seizures, and epilepsy: A systematic review and meta‐analysis

Abstract

SUMMARYPurpose: The purpose of this research was to analyze and quantify the association between alcohol consumption and epilepsy as an independent disease, in part operationalized by the occurrence of unprovoked seizures, as well as to examine causality. Methods: Systematic review, meta-analysis. Results: A strong and consistent association between alcohol consumption and epilepsy/unprovoked seizures was found with an overall relative risk (RR) of 2.19 [95% % confidence interval (CI) 1.83-2.63]. There was a doseresponse relationship between the amount of alcohol consumed daily and the probability of the onset of epilepsy. Individuals consuming an average of four, six, and eight drinks daily had RRs of 1.81 (95% % CI 1.59-2.07), 2.44 (95% % CI 2.00-2.97), and 3.27 (95% % CI 2.52-4.26), respectively, compared to nondrinkers. Several pathogenic mechanisms for the development of epilepsy in alcohol users were identified. Most of the relevant studies found that a high percentage of alcohol users with epilepsy would qualify for the criteria of alcohol dependence. Data were inconclusive regarding a threshold for the effect of alcohol, but most studies suggest that the effect may only hold for heavy drinking (four and more drinks daily). Discussion: The relationship between alcohol consumption and epilepsy and unprovoked seizures was quantified and several pathogenic mechanisms were suggested, although none of them has been proven to be the unique causative pathway for epilepsy. Certain limitations underlying this study require further research to clarify the outstanding statistical issues and pathogenesis of epilepsy in heavy drinkers.

Medical Presentations of Psychosis - Mimics and Life-Threatening Illnesses

“…Epilepsy is another disease causally impacted by alcohol, over and above withdrawal-induced seizures (Samokhvalov et al, 2010). Many other neuropsychiatric disorders are associated with alcohol, but whether they are caused or the extent to which they are caused by alcohol consumption is not clear.…”

The Relationship between Alcohol and Seizures: An Overview of the Major Data

“…The apparition of spontaneous seizures and epilepsy, defined by the International League Against Epilepsy as a disease of the brain generating at least two unprovoked seizures occurring >24h apart [45], requires the instauration of longterm antiepileptic drugs (AED) and the avoidance of alcohol withdrawal episodes. It is estimated that the duration of heavy alcohol consumption must reach a dozen years to produce repetitive unprovoked seizures [2,44].…”

“…A meta-analysis performed in 2010 by Samokhvalov and coworkers concludes to a relative risk (RR) for epilepsy/unprovoked seizures of 2.19 (95% confidence interval CI= 1.83-2.63) for alcohol consumers, compared to abstainers. These authors point out a dose-response relationship between the daily amount of alcohol intake and the RR of epilepsy, raising from 1.17 (95% CI=1.13-1.21) to 3.27 (95% CI = 2.52-4.26) for an individual daily alcohol consumption of 12g to 96g respectively [2]. It is likewise observed, in a multicenter case-control study performed in Italy, that an alcohol intake of more than 50 grams a day is a risk factor (odds ratio 4.9; confidence limits 3.1-7.9) for a first generalized tonicoclonic seizure in adult life (≥15 years) [3].…”

Targets and abuse: the price public health campaigners pay

“…Chapter 3, Appendix and country profiles Samokhvalov et al, 2010b;. Yes Cardiovascular diseases Hypertensive heart disease, ischaemic heart disease, ischaemic stroke, haemorrhagic stroke, atrial fibrillation and flutter, conduction disorders Taylor et al, 2009;Guiraud et al, 2010;Patra et al, 2010;Samokhvalov et al, 2010c;Roerecke & Rehm, 2010a,b, 2012.…”