The Connection Between Seizures and Alcohol
Chronic excessive alcohol use is associated with profound changes in brain chemistry, with two neurotransmitter systems being the most affected: The inhibitory neurotransmitter gamma-Aminobutyric acid (GABA) and the receptor for the excitatory neurotransmitter NMDA. The role of GABA in the brain is to limit excitability; thus, GABA inhibits excessive brain activity. NMDA, on the other hand, interacts with its receptor to excite cells in the brain. Under normal circumstances, these opposing chemicals cooperate to appropriately regulate brain activity, but alcohol use disorders increase the effects of GABA (excess inhibition of brain activity) and reduced the effects of NMDA (reduced excitation of brain activity). The net effect of excessive alcohol use is globally reduced brain activity that persists for as long as alcohol consumption continues. Abrupt cessation of alcohol use is associated with alcohol withdrawal seizures.
Ways Alcohol Can Cause Seizures
Severe alcohol withdrawal is well-characterized as a risk for seizures. Even in the 1960s, seizures that occurred during alcohol withdrawal were known as “rum fits.” The risk for seizures during withdrawal is correlated to the frequency and amount of alcohol consumed. While other mechanisms of alcohol-related seizures are less clear, reduced blood sugar levels and altered levels of ions in the brain are potential causes.
It is important to note that alcohol-related seizures and epileptic seizures are different. Alcohol-induced seizures do not meet the criteria for epilepsy and, with very few exceptions, alcohol consumption and seizures are not associated with the development of epilepsy.
- Seizures from alcohol abuse: Chronic alcohol abuse is generally associated with seizure activity only during withdrawal periods. Evidence that acute alcohol abuse (in the absence of alcohol poisoning and in non-epileptics) can cause seizures is scarce.
- Seizures from alcohol poisoning: Alcohol poisoning is a consequence of extreme binge drinking and can reduce blood sugar levels and alter concentrations of ions like magnesium and calcium in the brain. These changes may be sufficient to cause seizures, although the precise relationship remains an area of active research.
- Seizures from alcohol withdrawal: For someone with chronic alcohol use disorder, the risk of alcohol-related seizures is actually reduced while alcohol levels are high, but increases as alcohol is metabolized and withdrawal sets in. Abrupt cessation of alcohol removes the “brake” that has been limiting excitability as the brain tries to re-establish normal chemical levels by reducing GABA (increasing excitability) and increasing NMDA receptor activity (also increasing excitability). This process can lead to hyperexcitable brain states and subsequent seizure activity.
Prevention of Alcohol-Induced Seizure Problems
The most reliable way to prevent alcohol-induced seizures is with the prevention of alcohol abuse. Anything more than moderate alcohol consumption (a maximum of one daily drink for women and two for men) meets the criteria for alcohol use disorder and increases the risk of developing alcohol-related problems, including seizures.
Alcohol-induced seizures nearly always occur during withdrawal. For someone with a serious alcohol use disorder, withdrawal should only be attempted under the supervision of medical professionals who can intervene if complications arise. Oftentimes people going through withdrawal will be given a benzodiazepine to minimize the severity of symptoms and reduce the risk of brain hyperexcitability and subsequent seizure activity.
Alcohol use disorders are challenging to overcome. If you or someone you know is struggling with alcohol use, The Recovery Village Ridgefield can help. We offer comprehensive addiction treatment programs that can address all aspects of substance use and recovery.
Rogawski, Michael A. “Update on the Neurobiology of Alcohol Withdrawal Seizures.” Epilepsy Currents, November 2005. Accessed August 28, 2019.
Rhinehart, John W. “Factors Determining ‘Rum Fits’.” The American Journal of Psychiatry, September 1961. Accessed August 28, 2019.
Bråthen, Geir; et al. “Alcohol-related seizures.” European Handbook of Neurological Management, 2011. Accessed August 28, 2019.
Nordqvist, Christian. “What to know about alcohol poisoning.” Medical News Today, December 2017. Accessed August 28, 2019.
Halawa, Imad; Zelano, Johan; Kumlien, Eva. “Hypoglycemia and risk of seizures: A retrospective cross-sectional study.” Seizure, February 2015. Accessed August 28, 2019.
Samokhvalov, Andriy V; Irving, Hyacinth; Mohapatra, Satya; Rehm, Jürgen. “Alcohol consumption, unprovoked seizures, and epilepsy: A systematic review and meta‐analysis.” Epilepsia, July 2010. Accessed August 28, 2019.
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