Alcohol Abuse and Seizures
Seizure is the general term used to describe changes in body control or behavior brought about by chemical/electrical abnormalities in communication between nerve cells in the brain. They range in severity from minor, transient episodes to major, long-term events that can last 30 minutes or longer and seriously endanger a person’s life. Alcohol abuse is a known cause of seizure activity. Most alcohol-related seizures occur during alcohol withdrawal, but they can also occur in active drinkers. In some cases, alcohol abuse can worsen the effects of the seizure disorder epilepsy, or even trigger the onset of an epileptic state.
The brain functions through a combination of chemical messages and electrical impulses. The chemical messages come from substances called neurotransmitters, which pass from one neuron to another and attach themselves to sites on neuron surfaces called receptors. Electrical impulses occur inside the neurons in response to the chemical messages sent by neurotransmitters. The specific form and intensity of electrical activity inside any given neuron depends on the type of neurotransmitter that accesses its receptors. While there are dozens of neurotransmitters, two in particular have relevance in the development of seizures. One of these chemicals—glutamate—acts as the main exciter of electrical activity in neurons throughout the brain, while the other—gamma-aminobutyric acid (GABA)—acts as the main inhibitor or limiter of neuronal electrical activity.
A properly functioning brain relies on a balancing act between the influences of glutamate and GABA. GABA effectively controls this balancing act by making sure that glutamate doesn’t activate too many neurons. On a basic level, seizures occur when something upsets the balance between neuron activity and inactivity, and chaotic electrical patterns subsequently develop within the brain.
While the popular depiction of a seizure typically involves someone experiencing repeated, uncontrolled convulsions, seizures vary in both length and intensity. For instance, seizures known as petit mal or absence seizures typically last for no more than a few seconds and a trigger an abnormal lack of movement, not convulsions. Seizures called partial or focal seizures last for longer periods of time, affect only certain areas of the brain, and may or may not produce convulsions. Seizures called generalized tonic-clonic seizures (or grand mal) affect the entire brain and produce strong convulsions. A type of prolonged, potentially fatal seizure—known as status epilepticus—lasts for at least half an hour and may or may not produce convulsive activity. People who experience separate, repeated seizures have the ongoing condition called epilepsy.
Effects of Alcohol Withdrawal
The presence of alcohol in the brain can actually lower the likelihood of seizures in a person without a seizure history, according to a study published in 2003 in the journal CNS Drugs. However, the chances for a seizure rise significantly above average when alcoholics go through alcohol withdrawal. Generally speaking, withdrawal occurs when a brain accustomed to alcohol’s effects on its neurotransmitters reacts badly to a sharp drop in alcohol intake. The underlying mechanism of this poor reaction, which usually occurs within a six- to 48-hour window after cessation of drinking, is a rapid alteration in the brain’s relative levels of glutamate and GABA. A specific chemical change in the function of the brain’s GABA receptors helps trigger withdrawal-related seizure activity, researchers from Georgetown University Medical Center report.
Most people who develop seizures during alcohol withdrawal experience grand mal seizures, according to a study review published in 2005 in the journal “Epilepsy Currents.” In most cases, these seizures originate in the brain stem and radiate outward to other brain areas. Alcohol withdrawal is also the underlying cause of roughly 10 to 25 percent of all cases of status epilepticus. As stated previously, this type of seizure lasts for a minimum of half an hour, and may or may not involve the presence of convulsions. A person in the grips of status epilepticus is in a dire medical state that can result in permanent brain damage or death.
Effects of Alcohol Consumption
While most alcohol-related seizures occur during the withdrawal process, problems can also appear in heavy drinkers who have never gone through withdrawal. In drinkers who have epilepsy, alcohol’s effects can manifest as unusually lengthy or unusually severe seizure activity. In drinkers who don’t have epilepsy, heavy alcohol use can contribute to changes in brain function that encourage the onset of the seizure disorder. While grand mal seizures are still a relatively common seizure concern in active alcohol abusers and alcoholics, some people in these population groups develop cases of status epilepticus.