Are Patients With Alcohol-Related Seizures a Specific Subgroup?

OBJECTIVE: Alcohol-related seizures are acute symptomatic seizures most frequently associated with alcohol withdrawal. However, little is known about the phenotypic characteristics of patients with alcohol-related seizures. This study evaluated the clinical features and personality traits of alcohol use disorder patients with alcohol-related seizures. METHODS: This comparative correlational study assessed the clinical and psychological covariates of alcohol-related seizures. A total of 144 alcohol-dependent patients were recruited from an alcoholism unit from January 2017 to January 2019 and divided into 2 subgroups: alcohol-dependent patients reporting alcohol-related seizures and alcohol-dependent patients with no history of alcohol-related seizures. RESULTS: The alcohol-related seizures subgroup significantly started to abuse (F = 4.1, P = .019) and depend (F = 0.12, P = .008) on alcohol at an earlier age and had more alcohol detoxification episodes (F = 4.4, P = .048), a higher degree of alcohol dependence severity (F = 0.30, P = .009), and a more frequent family history of alcoholism (χ² = 4.9, P = .026). These patients also had lower levels of openness to experience (F = 4.0, P = .029) after adjustment for current age, age at onset of alcohol misuse and dependence, severity of alcohol dependence level, number of previous alcohol detoxifications, and family history. CONCLUSIONS: The findings will help clinicians better understand this subgroup of patients and highlight the importance of considering personality traits and other clinical features when tailoring treatment for these individuals.

Convulsões relacionadas ao alcoolismo: atualização / Seizures related to alcoholism: update

OBJETIVO: Revisão sobre crises convulsivas relacionadas ao alcoolismo,discutindo sua classificação, fisiopatologia, investigação diagnóstica e seu tratamento. MÉTODO: Revisão não sistemática de artigos utilizando-se os unitermos: "alcoholism", "alcohol", "seizures" e "withdrawal". Priorizou-se a utilização de artigos que apresentassem associação desses unitermos no título. Foram utilizadas as bases de dados do PubMed, Lilacs e Google Scholar. RESULTADOS: Foram encontrados 2.362 artigos associando os unitermos no título, tendo sido escolhidos 26 artigos em inglês, 3 em português, 1 manual e 1 tese em inglês para a elaboração desta revisão. CONCLUSÃO: As crises convulsivas relacionadas ao álcool representam uma das mais graves complicações do alcoolismo. O diagnóstico e o tratamento corretos melhoram o prognóstico desses indivíduos, diminuindo o risco de complicações, a recorrência de crises, a ocorrência de status epilepticus ou a evolução para um quadro de delirium tremens.

OBJECTIVE: Review alcoholism related seizures, discussing classification,pathophysiology, diagnosis and treatment. METHOD: A non-systematic review was performed of articles using the keywords: "alcoholism", "alcohol", "seizures", and "withdrawal". Articles with the combination of these keywords in the title were favored. The search was performed on PubMed, Lilacs database and Google Scholar. RESULTS: Using these search terms 2,362 articles were found, being selected 26 articles in English, 3 articles in Portuguese, 1 English manual, and 1 thesis in English to elaborate this review. CONCLUSION: Seizures related to alcohol are one of the most serious complications of alcoholism. The correct diagnosis and treatment improves the prognosis of these individuals, decreasing the risk of complications,seizure recurrence, status epilepticus and the progression to delirium tremens.

[Diagnostics and therapy of alcohol withdrawal syndrome: focus on delirium tremens and withdrawal seizure]. / Diagnostik und Therapie des Alkoholentzugssyndroms: Fokus auf Delirium tremens und Entzugskrampfanfall.

INTRODUCTION: Delirium tremens and withdrawal seizures are serious complications of an alcohol withdrawal syndrome. This review presents the diagnostic procedures required in case of the occurrence of a withdrawal seizure and delirium tremens as well as possible treatment options including prophylactic medication regimen for alcohol withdrawal syndrome. Furthermore non-pharmacological procedures accompanying delirium tremens and a potential integration of viewing videotapes of delirium tremens in the course of alcohol-specific therapy are discussed. METHODS: A systematic literature research using Pubmed has been carried out to find recent studies and review articles dealing with alcohol withdrawal syndrome. RESULTS AND DISCUSSION: Regarding the diagnostic algorithm in case of the occurrence of a withdrawal seizure or a delirium tremens basic diagnostic procedures and special diagnostics including neuro-imaging or cerebrospinal fluid puncture depending on patients' clinical condition have to be considered. Sedatives are important in treatment of alcohol withdrawal seizures and delirium tremens as well as in the prophylaxis of alcohol withdrawal syndrome. A long-lasting prescription of anticonvulsant medication in patients suffering from withdrawal seizure should be considered critically and can be carried out only under certain conditions.

Alcohol withdrawal syndrome: assessment and treatment with the use of the Clinical Institute Withdrawal Assessment for Alcohol-revised.

Alcoholism is a chronic, complex disease and addictive disorder. Sudden cessation of alcohol consumption can lead to alcohol withdrawal, an acute process with devastating and potentially life-threatening consequences. Assessment of alcohol withdrawal is key to a successful outcome. Appropriate assessment of withdrawal symptoms begins with the use of the revised Clinical Institute Withdrawal Assessment for Alcohol, which evaluates the presence and severity of withdrawal symptoms. The higher the patient's score, the greater the risk for experiencing serious withdrawal symptoms. Pharmacotherapy may be gauged to treat the symptoms according the score.