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The Relationship Between Alcohol and Seizures

a man lies on the ground after experiencing an alcohol seizure in his apartment  

In most cases, moderate alcohol consumption is not associated with seizure activity. However, there are specific cases where alcohol use increases the risk of seizures.

What Are Seizures?

Seizures are a consequence of abnormally high electrical activity in the brain. While there are several specific types of seizures, they can generally be categorized as focal or generalized seizures, depending on where in the brain the seizure activity begins.

  • Focal Seizures: When a seizure has a specific site, or “locus,” where abnormal electrical activity starts, the seizure is called a focal seizure. Focal seizures begin on one side of the brain.
  • Generalized Seizures: Generalized seizures are caused when the same areas on both sides of the brain experience electrical hyperexcitability.

Most people associate seizures with epilepsy. However, while people with epilepsy experience seizures, not all seizures are epileptic. Some reasons why people without epilepsy may experience seizures include drug or alcohol use, head trauma, or even extreme mental distress.

Does Alcohol Use Cause Seizures?

Moderate alcohol consumption is not associated with seizures. However, there are instances where extreme alcohol use can cause seizures. Before getting into specific cases where alcohol use can instigate seizures, it may be helpful to understand some of the effects that alcohol has on the brain.

Under normal circumstances, two major neurotransmitter signaling pathways cooperate to regulate brain activity: The inhibitory GABA signaling pathway, and the excitatory NMDA signaling pathway. Excessive alcohol use increases GABA signaling (reducing brain activity) and reduces NMDA signaling (also reducing brain activity). The net effect of alcohol is to reduce brain activity, so it is considered to be a central nervous system (CNS) depressant.

Because seizures are the consequence of brain hyperexcitability, in most cases, acute alcohol intoxication actually reduces the risk of seizure activity. Seizure risk is typically highest during withdrawal, when the brain is trying to reestablish normal GABA and NMDA-mediated activity levels.

Alcohol-Related Seizures

The majority of alcohol-related seizures occur in people with serious alcohol use disorders who suddenly quit drinking. However, there are other cases where alcohol may increase the risk of seizure in some people.

Seizures After Binge Drinking

Extreme binge drinking can cause alcohol poisoning, which is associated with a number of potentially dangerous physiological changes in the brain and body. When alcohol reaches a high enough level in the blood, significant changes in ion concentrations (primarily magnesium and calcium) in the brain or dangerously low blood sugar levels may increase seizure risk.

The precise relationship between binge drinking and seizure activity is unclear, and whether there are predisposing genetic or metabolic factors that contribute to seizures after binge drinking is not known.

Delirium Tremens/Alcohol Withdrawal

Most cases of alcohol-related seizures are seen in people with serious alcohol dependence and addiction. In these cases, the cause of seizures is not the presence of alcohol, but a sudden absence of alcohol. When someone is physically dependent on alcohol, their brain has become accustomed to the presence of alcohol, which persistently inhibits normal excitation of brain cells. If alcohol is suddenly absent, the brain rapidly tries to reestablish normal activity levels and hyperexcitation and seizure activity may occur. Alcohol withdrawal-induced seizures generally occur within 6 to 48 hours of alcohol discontinuation.

Delirium tremens are an extremely dangerous symptom of severe alcohol withdrawal. Although delirium tremens are not always associated with seizures, the presence of delirium tremens increases the risk of seizure activity.

Fetal Alcohol Syndrome

Fetal alcohol syndrome is a congenital disorder that is the direct consequence of prenatal exposure to alcohol. The more alcohol that a pregnant woman consumes, the higher fetal alcohol syndrome risk an infant has. The severity of fetal alcohol syndrome is also related to the amount of alcohol that is consumed.

A great deal of evidence shows that seizure disorders are significantly more likely to occur in infants with fetal alcohol syndrome. One study found that seizures are 3.15 times more likely to occur in infants with fetal alcohol syndrome compared to those without the disorder.

Alcohol Allergy

Alcohol intolerance, also known as alcohol allergy, is a genetic condition where the body cannot break down alcohol efficiently. Signs of an alcohol allergy most commonly include facial redness after alcohol consumption, rashes or hives, and gastrointestinal upset. Hangovers the day after alcohol use are often much worse than expected. A link between alcohol intolerance and seizure disorders may exist, but so far little scientific evidence has clarified the link.

Epileptic Seizure Triggered by Alcohol

Alcohol does not cause epilepsy, but excessive alcohol consumption increases the risk of epileptic seizures. In 2018, researchers asked 204 people with epilepsy about alcohol use and seizure activity. Every person who reported that alcohol had caused a seizure had consumed large amounts of alcohol in the 24-hour period before their seizure. Moderate alcohol consumption (two of fewer alcoholic drinks) did not cause seizures in any of the participants. Other studies have shown similar results, and there is a clear link between binge drinking and epileptic seizures.

Mixing alcohol and seizure medication can be risky. People with epilepsy who are on antiepileptic drugs should discuss alcohol use with their doctor. Several antiepileptic drugs can have negative interactions with alcohol, including reduced efficacy or respiratory depression. Some medications reduce tolerance to alcohol, meaning that someone will become intoxicated more quickly than normal.

Are Teenagers More Susceptible to Alcohol-Related Seizures?

While there is no definitive answer as to whether teenagers are more likely to experience alcohol-related seizures, it is clear that teenagers who use alcohol are at high risk for significant and irreversible brain damage. Alcohol impedes normal structural and functional brain development, which causes long-term memory impairment, increased frequency of mental health disorders (e.g., attention deficit disorder, depression, anxiety disorders) and increased risk of life-long alcohol and substance use disorders. In addition, the three top causes of teenage death (unintentional injury (48%), homicide (13%) and suicide (11%)) often involve alcohol use.

Little evidence exists that links alcohol use to the first seizure in teenagers who will be diagnosed with epilepsy, in part due to the difficulty in designing such a study. A study of 293 people with regular or chronic alcohol use or abuse did not find a significant link between alcohol use and the onset of the first symptomatic epileptic seizure.

Address Alcohol Abuse to Avoid Seizures

While there are currently no well-defined links between teenage alcohol use and the development of seizure disorders, indirect links are plentiful. The most effective way to avoid alcohol-related seizures is to not drink alcohol.

Teenagers are at a particularly high risk of alcohol-induced damage and long-term consequences, including memory loss, mental health disorders, and alcohol or other substance use disorders. In addition, teenagers and adults alike can experience alcohol withdrawal-induced seizures that occur when someone with a physical dependence on alcohol abruptly stops using it.

If you are concerned that your teenager is drinking, Next Generation Village can help. Our experts use evidence-based methods to help teens quit drinking alcohol and using drugs. Call today to learn more about a program that can work for your teen.

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