Alcohol Withdrawal Seizure
From Anvita Health Wiki
Contents |
Clinical-manifestations
- seizures occur in 10% of patients in alcohol withdrawal
- onset generally 6-48 hours after alcohol cessation
- frequently occur in binge drinkers (average duration of alcoholic binge is 2 weeks)
- usually generalized tonic- clonic (grand mal) seizure
- no prodome
- loss of consciousness is common
- multiple seizures in 60%
- generally <5
- occur relatively close together, generally within 6 hour period
- alcohol withdrawal seizures are a single event; multiple seizures should prompt workup of a different etiology [2]
Laboratory
- normal baseline EEG
Complications
Management
- supportive care
-
- phenytoin loading & long term therapy is not necessary
- barbiturates not recommended
- abuse potential
- narrow therapeutic index
- barbiturate withdrawal is associated with seizures
- haloperidol
- droperidol
- no intrinsic anti- seizure activity
- may be synergistic with benzodiazepines
- induce hypertension
- lower seizure threshold
- disrupt central temperature regulation
- status epilepticus (5% of alcohol-related seizures)
More General Terms
Additional Terms
References
- McMicken DB & Freeland ES Alcohol-related seizures. Pathophysiology, differential diagnosis, evaluation, and treatment Emergency Medicine Clinics of North America, 12:1057, 1994 PMID: [1]
- Medical Knowledge Self Assessment Program (MKSAP) 14, American College of Physicians, Philadelphia 2006
- National Guideline Clearinghouse EFNS guideline on the diagnosis and management of alcohol- related seizures: Report of an EFNS task force. European Federation of Neurological Societies ngc-guideline: [2]
