Alcohol-related seizures may be associated with more severe depression, alcohol dependence syndrome, and more pronounced alcohol-related problems

Gutmane, Evija; Sūna, Normunds; Tomilova, Anastasija; Liepiņa, Lelde; Folkmanis, Valdis; Karelis, Guntis

doi:10.1016/j.yebeh.2018.10.023

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…In our follow‐up study, the severity of alcohol dependence was measured by using the AUDIT, and the present results revealed that although significant differences between the two groups were not detected, patients with ARS showed slightly higher AUDIT scores. Previous observations have also demonstrated that there are no significant differences in the AUDIT scores between both groups 44 . Previously, AUDIT has been examined as a predictor tool for the development of AWS 47,48 .…”

Section: Discussionmentioning

confidence: 94%

“…24,[30][31][32][33][34][35] By demonstrating that the presence of DT has an explanatory role in developing ARS, our results support these observations. Moreover, although several reports have evaluated that various factors such as older age, male sex, high blood level of homocysteine, low platelet count, low potassium level, and psychiatric and somatic co-morbidities can be risk factors for developing DT, 19,36,[43][44][45] the interplay of the occurrence of ARS and DT has not been evaluated in detail. Some studies have suggested that the ARS in medical history can increase the risk of the development of DT via the kindling mechanism.…”

Section: Discussionmentioning

confidence: 99%

“…Previous observations have also demonstrated that there are no significant differences in the AUDIT scores between both groups. 44 Previously, AUDIT has been examined as a predictor tool for the development of AWS. 47 , 48 These observations revealed that AUDIT alone is not suitable to detect the risk of AWS.…”

Section: Discussionmentioning

confidence: 99%

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Characterization of alcohol‐related seizures in withdrawal syndrome

Kádár,

Gajdics,

Pribék

et al. 2024

Epilepsia Open

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ObjectiveAlcohol‐related seizures (ARS) are one of the most important consequences of alcohol withdrawal syndrome (AWS). However, demographic and clinical characteristics, and furthermore, the relationship of ARS with delirium tremens (DT), have not yet been evaluated in detail. Therefore, the aim of the present study was to reveal the correlates of ARS and examine the interaction of ARS with the occurrence of DT and with the severity of AWS.MethodsIn the retrospective study (Study 1) 2851 medical charts of inpatient admissions characterized by AWS and DT were listed. Demographic and clinical variables of ARS were assessed. In the follow‐up study (Study 2), patients admitted with AWS without (N = 28) and with (N = 18) ARS were enrolled. Study 1 was performed between 2008 and 2023, and Study 2 was performed in 2019 in Hungary. To determine the severity of AWS, the Clinical Institute Withdrawal Assessment Scale for Alcohol, Revised (CIWA‐Ar) was used. ARS is a provoked, occasional seizure; therefore, patients with epilepsy syndrome were excluded from the two studies. Statistical analyses were performed by the means of chi‐square tests, multinomial logistic regressions, mixed ANOVA, and derivation.ResultsThe occurrence of DT, the history of ARS, and somatic co‐morbidities were found to be risk factors for the appearance of ARS. ARS was proved to be a risk factor for the development of DT. In the follow‐up study, there was no difference in the decrease of CIWA‐Ar scores between the groups.SignificanceOur present findings support the likelihood of kindling, which is one of the most important mechanisms underlying the development of ARS, but do not directly prove its presence. Additionally, our results revealed that the severity of AWS is not influenced by the presence of ARS.Plain Language SummaryProvoked, occasional seizures during AWS are defined as ARS. In the present study, predictors and interactions of these seizures with DT—the most severe form of withdrawal—and with the severity of withdrawal were examined in retrospective and follow‐up studies. The present study shows that a history of withdrawal seizures, the occurrence of DT, and somatic comorbidities are predictors of the development of seizures. Furthermore, our findings suggest that the presence of seizures does not influence the severity of withdrawal.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Characterization of alcohol‐related seizures in withdrawal syndrome

Kádár,

Gajdics,

Pribék

et al. 2024

Epilepsia Open

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“…• współwystępowanie innych obciążeń, takich jak depresja, choroby serca i układu oddechowego, zapalenie trzustki, stan po urazie głowy, odwodnienie, wyniszczenie, małopłytkowość czy zaburzenia elektrolitowe (zwłaszcza hiponatremia) (Gutmane et al, 2019;Habrat et al, 2012, Silczuk et al, 2019.…”

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Seizures in alcohol withdrawal syndrome

Lasocka¹,

Konopko²,

Basińska-Szafrańska³

et al. 2020

Aktualn Neurol

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Alcohol withdrawal syndrome develops in individuals with alcohol dependence who discontinue or reduce alcohol intake after long-term or binge drinking. Withdrawal symptoms usually occur 6–8 hours after the last alcohol consumption and peak between 24–72 hours. Typical manifestations include tremor, nausea, vomiting, insomnia, agitation, and excess sweating. Complicated withdrawal syndrome may manifest with seizures (including cluster seizures), status epilepticus, acute psychosis and delirium, when hallucinations are accompanied by disorientation in time, place and situation. About 10–15% of patients develop complicated withdrawal syndrome. The seizures in alcohol withdrawal syndrome are triggered in the brain stem and have a mechanism other than that of classic epileptic seizures. Benzodiazepines, which are more effective than other classes of anticonvulsants (they primarily reduce the frequency of convulsions in the first two days after alcohol discontinuation and significantly reduce the risk of death), are the gold standard for the treatment of alcohol withdrawal syndrome. The Clinical Institute of Withdrawal Assessment for Alcohol Scale (CIWA-Ar) is a helpful tool for making decisions on treatment initiation or discontinuation. It should be noted that chronic use of benzodiazepines in the secondary prevention of alcohol withdrawal seizures is not recommended due to the addictive potential of these agents and a more severe course of alcohol withdrawal seizures with benzodiazepine co-dependence.

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