Alcoholic epilepsy: Review of a series and proposed classification and etiopathogenesis

Devetag, F.; Mandich, Gillian; Zaiotti, G.; Toffolo, G. G.

doi:10.1007/bf02043479

Cited by 32 publications

(35 citation statements)

References 21 publications

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“…The literature in this field suffers from the lack of a unanimous definition,41 42 which makes the reproducibility of results difficult. Whereas the withdrawal seizure is closely linked to cessation or abrupt reduction of an increased alcohol intake,14 other alcohol related seizures may not be directly related to a drinking bout 5.…”

Section: Discussionmentioning

confidence: 99%

Validity of carbohydrate deficient transferrin and other markers as diagnostic aids in the detection of alcohol related seizures

Bråthen

Bjerve²,

Brodtkorb³

et al. 2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Objective-The role of alcohol misuse in the genesis of seizures is probably often undetected. The aim was to investigate the utility of carbohydrate deficient transferrin (CDT) compared with other biomarkers and clinical examination in the diagnosis of alcohol related seizures. Methods-The study included consecutively 158 seizure patients-83 men and 75 women-with mean age 45 (16-79) years. Seizures related to alcohol use were identified by a score >8 in the alcohol use disorders identification test (AUDIT positive). AUDIT was applied as the gold standard to which sensitivity and specificity of the various markers were related. Blood samples were obtained from 150 patients on admission and analysed for ethanol, liver enzymes, and CDT, using AXIS Biochemicals' %CDT-TIA kit. Results-53 patients (34%) were AUDIT positive. Using the commonly applied decision value for %CDT of 5.0%, a sensitivity of 41% and a specificity of 84% were obtained. Analysis of receiver operator characteristics (ROC) curves disclosed an optimal cut oV value for %CDT of 5.4%, which yielded a sensitivity of 39% and a specificity of 88%. At a specificity of 80%, the sensitivity was 43% for %CDT and 26% for GGT. The %CDT sensitivity was markedly higher for men than for women. Compared with GGT, ASAT, ALAT, and ASAT/ALAT ratio, CDT was the best single biomarker for alcohol related seizures. However, even in the subgroup of withdrawal seizures, the sensitivity level barely exceeded 50%. Clinicians scored alcohol as the main cause of the seizure in only 19 cases (12%). In 38 (24%) cases, clinicians suspected that alcohol had a role (sensitivity of 62% at a specificity of 89%). Their ability to identify AUDIT positive patients was better than that of any biomarker, but many cases were missed. Agreement of clinicians' scores to CDT was only fair ( =0.28). CDT concentrations were significantly increased among alcohol abstaining patients on enzymeinducing antiepileptic drugs. Six out of 16 patients with false positive CDT results were exposed to such drugs. Conclusions-CDT is not recommended as a stand alone marker for alcohol related seizures, but may provide a useful contribution to the overall diagnostic investigation of seizures. Confirmatory studies are needed as to the apparent vulnerability of CDT to antiepileptic drugs. (J Neurol Neurosurg Psychiatry 2000;68:342-348)

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Section: Discussionmentioning

confidence: 99%

Validity of carbohydrate deficient transferrin and other markers as diagnostic aids in the detection of alcohol related seizures

Bråthen

Bjerve²,

Brodtkorb³

et al. 2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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“…Even though it is not mentioned in the ICE (Commission, 1989), alcoholic epilepsy represents a real syndrome, defined as ''recurrent seizures occurring in alcoholics not previously epileptic, not suffering from other potentially epileptogenic diseases and not related to either a sudden withdrawal or massive intake of alcohol" (Devetag et al, 1983), or "recurrent unprovoked seizures without obvious antecedents, developing after the onset of drinking and unrelated to withdrawal" (Hauser et al, 1988). Some adult patients with an isolated seizure will later develop alcoholic epilepsy.…”

Section: Crypto-symptopathic Genic Maticmentioning

confidence: 99%

Classification of Epilepsies and Epileptic Syndromes in Two Different Samples of Patients

1991

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We attempted to classify, according to the International Classification of Epilepsies and Epileptic Syndromes, 986 patients consecutively examined during a 13-month period either in a specialized private practice (n = 642) or in an adult neurology unit in a university hospital (n = 344). Without major difficulty, we classified 97% of patients in more or less clearly defined syndromes. Benign frontal and benign psychomotor epilepsies of childhood were represented in this sample of patients. In either partial or generalized idiopathic epilepsies, a diagnosis of epilepsy appears justified even after a single epileptic event when sufficient electroclinical characteristics are present. Patients with symptomatic generalized epilepsies often have to be classified under two or three headings. Many children with a symptomatic generalized epilepsy also experience partial seizures. Alcoholic epilepsy is described as a veritable epileptic syndrome. The distribution of epileptic syndromes was clearly different in the two samples, casting doubt on the value of some epidemiologic surveys based on selected groups of patients.

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“…Cerebral atrophy as determined by computer tomography (CT) has shown no differences between those alcoholics with seizures and those without [33]-Devetag et al [34] have reported essentially different findings from those of others, although they are in agreement with another substantial series [35] that very roughly io% of all alcoholics experience seizures at some time. Of Devetag's large series of x435 patients, x53 had a history of seizures.…”

Section: Alcohol and Seizuresmentioning

confidence: 71%

Neurological complications of alcohol usage

Price

1991

Drug and Alcohol Review

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The relationships between alcohol usage and a number of neurological syndromes are reviewed. These are often complex and incompletely understood. Multiple rather than single factors are the rule rather than the exception. The correct diagnosis may be missed particularly where the aetiological role of alcohol is overlooked. Multiple diagnoses are not uncommon. Issues of differential diagnosis and diagnostic procedures are discussed. Management, including a number of its pitfalls, is outlined.

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Alcoholic epilepsy: Review of a series and proposed classification and etiopathogenesis

Cited by 32 publications

References 21 publications

Validity of carbohydrate deficient transferrin and other markers as diagnostic aids in the detection of alcohol related seizures

Validity of carbohydrate deficient transferrin and other markers as diagnostic aids in the detection of alcohol related seizures

Classification of Epilepsies and Epileptic Syndromes in Two Different Samples of Patients

Neurological complications of alcohol usage

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