Alcohol Withdrawal and Seizures

Alcohol Withdrawal and Seizures: 

The risk of a seizure during alcohol withdrawal is a fear of many alcohol dependent drinkers. The risk of seizures and the risk of DT's or Delirium Tremens is a key reason alcoholic dependent drinkers reach out for professional help. 

What is the actual risk for alcohol related seizures? 

Seizures are a serious concern and given this concern we will cite information from the "Treatment Improvement Protocol" series titled: Detoxification and Substance Abuse Treatment.

There is no great certainty in prediction who will have a seizure. There are a number of generalities related to the risk of seizures: They are: 

• There is a 2-3% chance that someone in alcohol withdrawal will have a seizure. 

• Once a person has an alcohol related seizure they are at greater risk to have another seizure during withdrawal. 

• The risk of seizures goes up significantly if a person has had three alcohol related seizures in the past. 

• Seizures, when the do occur usually occur in the first 48 hours. However seizures have been know to occur later. 

• Active drinking for two or more decades increase the incidence of seizures. 

• Poor general health and / or nutrition. 

• Previous head injuries. 

• Electrolyte imbalance: Calcium, Sodium, Potassium, or Magnesium disturbance. 

How to Prevent Seizures: 

The best way to prevent seizures related to alcohol use is with proper medication management. The judicious use of a benzodiazepine or phenobarbital can significantly decrease the risk of a seizure. The proper use of a benzodiazepine or phenobarbital should be managed under medical supervision. In addition, if a person does have an alcohol withdrawal induced seizure, they should ideally be given a benzodiazepine as soon as possible. 

What to do if a person has an alcohol related seizure?

If a person does have a seizure, do the following: 

1. Call 911. A call to 911 should be made in any outpatient setting and should be made in any Level III detox program that is separated from an inpatient medical hospital. 
2. Observe the seizure and time the seizure if possible. 
3. Do not put anything in the person's mouth. Place the person on his or her side if there is any frothing or vomiting. 
4. Anticipate the person will be confused.  Orient, assure and attempt to calm the person as they come to consciousness. 

Our Experience with Alcohol Withdrawal and Seizures:

Executive Home Detox has participated in over 100 alcohol related detoxifications. We have been fortunate to not have any of our clients experience seizures. We attribute this to aggressively medicating the client early in withdrawal, per physician's orders, and then doing an appropriate taper. As nurses, we have observed and treated seizures for other reasons.