Alcohol Related Seizures in Chronic Alcoholics / 대한간질학회지

PURPOSE: Alcohol related seizures (ARS) are common problems in community. We reviewed the clinical characteristics of ARS in chronic alcoholics and evaluated the predictors of delirium tremens and recurrence of seizures. METHODS: We thoroughly reviewed all medical records of patients with alcohol related seizures at admission and some outpatient records for follow-up data. For the patients who had been lost during follow-up, telephone interviews were performed. We described the clinical characteristics of ARS during admission and analyzed the correlation between initial findings of ARS. RESULTS: Forty eight patients with ARS were admitted and followup data were available in 33 patients by out-patient records or telephone interviews. Forty-four patients were male and the mean age was 47.4+/-10.4 years old. Nine out of 33 patients became completely abstinent after discharge. Ten out of 24 current drinkers developed recurrent seizures and 20 out of 48 patients developed delirium tremens (DT) during admission. The number of seizures and age ofpatients were significantly related with DT. Patients with much weekly- consumption of alcohol were prone to develop recurrent seizures. CONCLUSIONS:These results suggest that careful attention should be paid to the patients with older age and multiple seizures at each event about the development of DT and to the patients with much weekly-consumption of alcohol about the recurrence of seizures during follow-up.

Seizures in Chronic Alcoholics / 대한간질학회지

PURPOSE: Seizures constitute one of the most frequent medical complications in alcoholics. The purpose of this study is to elucidate clinical characteristics of seizures in chronic alcoholics. METHODS: Subjects were 50 alcoholics with seizure who were admitted to Kang-Dong Sacred Heart Hospital between Jan. 1999 to May. 2002. We classified them into alcohol withdrawal seizure (AWS) and alcohol related seizure (ARS). AWS was defined as 1) seizures occur within 72 hrs after the last alcohol intake and 2) occurring in the patients without focal abnormalities on brain CT and EEG. ARS was defined as 1) seizures occurring more than 72 hrs after the last alcohol intake, 2) occurring regardless of onset-time in the patients who had concomitant focal brain lesions or focal abnormalities on EEG, and 3) occurr in patients who had experienced seizure unrelated with alcohol. Their clinical, electrophysiologic and neuroradiologic features were analyzed. RESULTS: 45 patients (90%) were male. Mean age was 47 years. 48 patients (96%) were presented with generalized tonic-clonic seizure. 28 patients (56%) were classified into AWS and 22 (44%) into ARS. Mean age was 46 years in patients with AWS and 54.9 in ARS (p=0.04). Mean duration of alcohol intake was 17 years in AWS and 26.2 in ARS (p=0.002). Mean amount of alcohol intake (yrs x bottles/day) were 30.3 in AWS and 42.0 in ARS (p=0.061). EEG showed diffuse slowing in 5 of AWS, sharp waves in 4 of ARS, focal slowing in 3 of ARS and PLEDs in one of ARS. Among 28 patients with AWS, only one patient was treated with long term antiepileptic drugs (AED). Among 22 ARS, 14 (64%) patients were treated with long term AED. One patient of each group experienced recurrent seizure during follow up. Delirium tremens was developed in 17 patients (34%). Among them, 13 (76%) had alcoholic liver disease (p=0.036). CONCLUSIONS: Our study suggests that patients with ARS were older and drunk more for a longer period of time than patients with AWS. Long term AED administration may be required to prevent recurrent seizures in patients with ARS. On the other hand, delirium tremens may be significantly associated with alcoholic liver disease.