Weekly binge drinking [1] has become its own pocket of UK culture, with most people enjoying a tipple or two to wind down after a long working week.
These ritualistic beverages are, for many people, easy to recover from and will rarely lead to long-term health complications.
However, due to a complex combination of biological, social, and environmental stressors, more people than ever before are developing Alcohol Use Disorders: a chronic condition that’s more than just a drinking problem.
This disease impacts the brain, body, and central nervous system in worrying ways, with many people at risk of developing seizures when undergoing their alcohol detox [2].
In this article, we’ll break down the risks associated with alcohol-induced seizures, what causes them, who’s most at risk, and how to treat them.
While it can be an anxiety-provoking topic to read about, it’s important to be aware of the risks associated with alcohol withdrawal, whether you or someone you know is going through the recovery process.
What are Seizures?
Normally associated with conditions such as epilepsy, seizures can occur for several reasons and may manifest after a head injury, due to an infection, or a condition affecting the brain such as substance abuse.
Nonepileptic seizures such as those occurring during alcohol withdrawal either occur once or across a period between 1-6 hours.
Described as “electrical storms” in the brain, seizures are a sudden burst of neurological energy that disrupts the way messages are sent between cells.
Also known as neurons, these nerve cells receive and send electrical impulses that make it possible for us to function normally.
Due to this abrupt surge in electrical activity, victims will experience dramatic and noticeable symptoms, especially if they are suffering from a tonic-clonic or grand mal seizure (the most severe form).
These include repetitive jerking, stiffening, frothing at the mouth, and losing control of one’s bowel/bladder function.
Oftentimes, people will lose consciousness for around 2 minutes and have no memory of the event as they slowly wake up. However, in severe cases, alcohol withdrawal seizures [3] can last for 5 minutes or longer and occur repeatedly.
Without medical attention, this can lead to a fatal condition known as status epilepticus: a medical emergency carrying the risk of brain damage.
When Do They Occur? Alcohol Detox & Withdrawal Explained
You might be wondering if you can suffer from an alcohol-induced seizure after a typical Saturday night out. While seizures have been linked to binge drinking episodes.
It’s especially among those with epilepsy, this isn’t the most high-risk situation. It’s when someone attempts detoxification for alcohol that they’re at the most risk of seizures.
Experts have noted that most alcohol-related seizures [4] occur in detox, or more specifically, during unsupervised detoxification from alcohol.
This is the process of allowing the body to eliminate alcohol and its toxins naturally. As it’s flushed from the bloodstream, the body attempts to adjust itself to the absence of alcohol: which can be a tricky process for many alcohol drinkers.
For someone who isn’t physically dependent on alcohol, quitting drinking will be a fairly easy process and their risk of seizures will be particularly low. However, for those with an Alcohol Use Disorder (AUD), the first 24-48 hours after their final beverage increases the danger tenfold.
This is because someone who has been used to drinking each day for many months or years has undergone worrying changes to their brain: the organ responsible for seizures.
Due to these changes, which we’ll go on to explain shortly, the brain struggles to function without the presence of alcohol and tries to compensate in self-destructive ways.
It’s also important to note that while alcohol withdrawal seizures [5] are most common in the first 48 hours of detox, this is by no means a definitive time frame.
Some people might appear to be out of the danger zone before suddenly developing the warning signs of an impending seizure.
This goes to show that not everyone’s recovery is linear, and severe symptoms can occur beyond the supposed seizure threshold. With this in mind, it’s crucial to receive medical advice and remain under constant supervision during detoxification from alcohol.
What Causes Alcohol Withdrawal Seizures?
So, what causes the close link between alcohol withdrawal syndromes and seizures? To answer this question, addiction treatment experts have conducted numerous studies and analysed countless brain imaging scans.
While a lot is still unknown about how the brain operates, the way it reacts to alcohol is something that has received a lot of scientific attention.
Deciding to stop drinking is a cause for celebration, but for many people entering recovery, even mild symptoms can cut the joy they felt at making this choice short.
If they are attempting to detox at home without medical support, they are likely doing so cold turkey: a dangerous situation to be in.
Their brain will react to the sudden lack of alcohol in their system [6], and the more a person has been used to drinking, the higher their risk of alcohol withdrawal seizures. This is because the shock to their central nervous system will be greater following the depressive effects of alcohol.
When we consume alcohol regularly, the drug has a profound effect on our central nervous system, a complex network that’s responsible for sending messages to and from the brain.
As a depressant, alcohol slows down the nervous system to produce the coveted symptoms that come with being drunk: relaxation, social lubrication, and euphoria.
But how does alcohol produce these worrying effects? It all comes down to the important neurotransmitter known as GABA.
This chemical is responsible for regulating the central nervous system: helping humans react appropriately to perceived threats, reducing stress and preventing dangerous events such as seizures.
However, the chemicals in alcohol reduce our GABA production and leave our brains woefully depleted of this stabilising substance.
The longer someone has been drinking, the more concrete the adaptations to their brain and nervous system have become, and the more likely they are to experience a “rebound effect” during detox and inpatient treatment.
The rebounding effect means that when alcohol is taken away, an addicted person’s nervous system is so used to being depressed that it sparks back to life.
While trying to function normally, it’s common for the central nervous system to go into overdrive [7], and it’s this surge in activity that causes tonic-clonic seizures.
As previously mentioned, this sudden electric storm in someone’s brain is more likely to cause a tonic-clonic seizure: an especially severe form.
This type produces the effects that people normally associate with seizures: which include both tonic (stiffening) and clonic (jerking or switching) phases.
It’s during these seizures that victims are at risk of sustaining life-threatening injuries, either from losing consciousness and hitting their head, or swallowing their tongue during convulsions.
Before this occurs, some people receive what’s known as an aura: a phenomenon where their brain signals an oncoming seizure.
For example, someone might feel an overwhelming sense of déjà vu, or an upset stomach feeling akin to motion sickness. However, these auras are more common in those who have experienced seizures before their alcohol detox.
While alcohol withdrawal seizures can be one-off events, they can also manifest as part of a life-threatening condition known as Delerium Tremens (DT) [8].
This is treated as a medical emergency and requires inpatient care to stop sufferers from succumbing to life-threatening symptoms.
Delerium Tremens & Seizures: Alcohol Withdrawal At Its Worst
Due to the likelihood of seizures and cardiac arrest, Delirium Tremens is considered the most dangerous form of alcohol withdrawal.
While it’s not common (affecting between 3-5% of those who experience withdrawal symptoms), the effects can be life-threatening and develop rapidly.
Typically, the first round of symptoms that someone with DT will exhibit include shaking, fever, vomiting, rapid heartbeat, and hallucinations.
The term “Delerium” refers to the worrying psychological side effects, which usually appear as confusion and agitation, with victims often not knowing where they are.
Symptoms such as confusion and nausea may develop suddenly, while seizures are most likely to occur in the following 1-3 days. However, as with all other elements of Alcohol Use Disorder, it’s not always possible to predict each person’s experience.
Regardless, without proper medical attention, victims of DT will soon develop more life-threatening symptoms, such as seizures and cardiac issues.
Additionally, reaching the later stages of DT will increase the risk of lifelong complications such as nerve damage, alcoholic cardiomyopathy, liver disease, and Wernicke-Korsakoff syndrome [9].
Also known as Wet Brain Syndrome, Wernicke-Korsakoff can cause irreversible brain damage to the regions of the brain associated with memory.
Worryingly, it can also inflict damage on the thalamus and hypothalamus: leading to muscle problems and trouble hearing, seeing, or feeling certain sensations.
As with other life-threatening withdrawal symptoms, Delerium Tremens is catalysed by overexcited neurotransmitters used to being suppressed by alcohol.
With this in mind, DT and associated seizures usually occur in heavy, long-term drinkers. Their risk becomes even higher if they’ve experienced severe withdrawal symptoms before, or have returned to their old drinking patterns post-detox.
This link between Alcohol Withdrawal Delirium [10] and chronic, heavy drinking has been explored by many experts in an attempt to optimise addiction treatment.
They’ve discovered that people who undergo multiple relapses are more likely to need medical treatment during detox, and are more a risk of severe symptoms such as seizures.
Who Are Most At Risk of Developing Alcohol Withdrawal Seizures?
It’s a sad reality that Alcohol Use Disorder is characterised by relapse, with sufferers likely to start drinking again if they don’t have the proper coping mechanisms in place.
Not only can this cause people to lose hope and worry they might never recover, but it can also heighten their risk of seizures when they next detox.
In recent years, scientists have discovered that repeated relapses and detox stints increase someone’s risk of enduring alcohol withdrawal seizures.
Aptly, this has been named “the kindling effect” [11], as every incident of withdrawal is thought to irritate the brain a little more each time it occurs.
After repeated attempts to detox, it’s almost as though the body develops its own post-traumatic response from previous withdrawal events. This is because neurological synapses in the brain react more abruptly to a negative stimulus such as undergoing unwanted symptoms.
Further scientific research has confirmed that this increased neurological activity has a direct link to withdrawal seizures.
One study found that a worrying 48% of respondents treated for AUD and who had seizures during detox had been through withdrawal multiple before.
In contrast, only 12 percent of those who had no seizures had been through the same number of withdrawal experiences.
As you can imagine, it’s incredibly important that those who have tried to detox before receive medical care during subsequent attempts.
While their risk of experiencing alcohol withdrawal seizures is high, there are a number of medications and long-term treatments that can remove this danger.
Treating seizures can be divided into two phases: short-term prevention and long-term prevention. While it’s crucial to detox in a controlled way that avoids seizures, long-term therapy to treat the root causes of AUD is just as important.
Treating Alcohol-Induced Seizures: The Medicated Detox
Here at OK Rehab, it’s rare that we advise someone to try and detox from alcohol at home, and never without consulting a physician before the event.
If you’re detoxing at home and haven’t got anyone there to supervise you, there’s nothing you can do to stop yourself from having a seizure as you won’t have access to expert care.
As we’ve now explored in depth, alcohol detox is considered a medical emergency and requires clinical supervision. The best way for someone to prevent and treat alcohol withdrawal seizures is to consider a medicated detox.
Fortunately, medicated detox programmes [12] are available on both an inpatient and outpatient basis, depending on your addiction severity.
If during your medical evaluation, your care team deems your seizure risk to be low, they’ll suggest an outpatient detox and design a bespoke taper.
During an outpatient detox, patients won’t stay overnight in a clinic but are instead required to visit their doctor’s office daily or bi-daily. Regularly visiting a clinic allows their care team to monitor their health and prescribe anti-seizure medications if needed.
This form of detox typically takes between 1-3 weeks depending on how much alcohol is present in someone’s system, and how long they’ve been drinking hazardously.
To avoid symptoms of alcohol withdrawal, patients will have a tapering schedule designed for them outlining how much they should reduce their alcohol dose by each day/week.
Despite this, the individualized treatment received in outpatient settings has its limitations. If someone has a high risk of Alcohol Withdrawal Delirium and tonic-clonic seizures, it’s dangerous for them to remain at home without consistent monitoring.
To prevent seizures and other symptoms of alcohol withdrawal from occurring, undertaking an inpatient detox is highly encouraged. This intensive form of detox takes place in a hospital or rehab clinic: requiring patients to stay overnight and receive medical support.
Health professionals monitor their patient’s heart rates and blood pressure o ensure their risk of focal seizures remains low and may prescribe tailored medications [13].
Prescribing a benzodiazepine for alcohol withdrawal is a popular treatment for those at risk of focal seizures, and helps many people pass their detox comfortably.
Drugs such as Valium can prevent generalized seizures, alongside generic symptoms of withdrawal like anxiety, insomnia, and other risk factors such as high blood pressure.
These medications work to prevent focal seizures by binding to the same neurotransmitters in the brain as alcohol, including GABA.
Unlike alcohol, however, benzos can help increase GABA activity: suppressing the central nervous system and providing a sense of calm. This clinical management has the added benefit of reducing alcohol cravings and helping patients reduce other alcohol withdrawal symptoms.
For patients at risk of generalized seizures but who can’t take benzodiazepines, other antiseizure medications [14] are available. Preferred agents include topiramate (also used to treat epileptic seizures) and acamprosate to help regulate brain chemistry.
Long-Term Treatment & Relapse Prevention
After completing treatment for alcohol withdrawal and overcoming the immediate seizure risk, those in recovery must tackle the root cause of their alcohol abuse.
Unfortunately, recovering from episodes of alcohol withdrawal does little to remove the long-term risk of seizures, and individualized treatment is needed to overcome AUD.
To facilitate lifelong recovery from alcohol addiction, it’s important to receive outpatient management for your condition or opt for a stint at a residential rehab.
Inpatient treatment can be accessed easily following a medical alcohol detoxification, and many bespoke recovery programmes are available in the UK.
At a rehab clinic specialising in Alcohol Use Disorders, you’ll receive 28 days of individual therapy, long-term medical assistance, and holistic treatments.
A typical round of inpatient treatment includes behavioural interventions, individual counselling sessions, and access to 12-step groups such as Alcoholics Anonymous.
When combined, these therapeutic methods [15] help you cultivate a relapse prevention plan and cope with everyday stressors to avoid returning to alcohol.
Methods such as Cognitive Behavioural therapy (CBT) and Motivational Interviewing (MI) allow you to heal from past trauma and rewire the negative thoughts powering your addiction.
Seeking Professional Help
Whether you’re looking to detox from alcohol safely or know someone who might be at risk of alcohol withdrawal seizures, the time to act is now.
With many members of our team having been through recovery themselves, we understand better than most how daunting it can be to reach out for help.
By calling our expert team on 0800 326 5559, or completing our online form to make an enquiry, you’ll be closer to achieving recovery or helping someone else do the same.
During your phone consultation, we’ll help you plan the next steps of your healing journey [16], whether this be arranging a medicated detox, accessing inpatient care, or another form of individualized treatment.
References
[1] Alcohol consumption: advice on low-risk drinking Alcohol consumption: advice on low-risk drinking – GOV.UK (www.gov.uk)
[2] The 10-Day Alcohol Detox Plan: Stop Drinking Easily and Safely The 10-Day Alcohol Detox Plan: Stop Drinking Easily and Safely – Lewis David – Google Books
[3] NHS: What to do if Someone Has a Seizure What to do if someone has a seizure (fit) – NHS (www.nhs.uk)
[4] Alcohol and the Nervous System Alcohol and the Nervous System – Google Books
[5] Evidence-based Screening and Assessment for Alcohol Withdrawal in the Acute Care Setting Evidence-based Screening and Assessment for Alcohol Withdrawal in the Acute … – Debra McAninch – Google Books
[6] The Addiction Solution: Unravelling the Mysteries of Addiction Through Cutting-Edge Brain Sciencehttps://books.google.co.th/books?id=_HlQfxWyJogC&printsec=rontcover&dq=valium+addiction&hl=en&sa=X&redir_esc=y#v=onepage&q=valium%20addiction&f=false
[7] Neuroscience of Alcohol, Mechanisms and Treatment Neuroscience of Alcohol – Google Books
[8] Remarks on the History and Treatment of Delirium Tremens Remarks on the History and Treatment of Delirium Tremens (Classic Reprint) – Google Books
[9] Wernicke-Korsakoff Syndrome, The Best Science in Everyday Language Wernicke-Korsakoff Syndrome – Google Books
[10] Ok Rehab: Alcoholism Causes and Risk Factors Alcoholism Causes and Risk Factors – OK Rehab
[11] Kindling in Alcohol Withdrawal Kindling in Alcohol Withdrawal (nih.gov)
[12] Ok Rehab: Medically Assisted Therapy (MAT) for Addiction Medically-Assisted Therapy (MAT) for Addiction | OK Rehab
[13] A Prescription for Alcoholics: Medications for Alcoholism Medication Assisted Treatment with Acamprosate, Baclofen, Topiramate, Naltrexone, Nalmefene and More https://www.google.co.uk/books/edition/A_Prescription_for_Alcoholics_Medication/DxItjwEACAAJ?hl=en
[14] Clinical management of alcohol withdrawal: A systematic review Clinical management of alcohol withdrawal: A systematic review – PMC (nih.gov)
[15] Ok Rehab: Addiction Counselling Addiction Counselling – OK Rehab
[16] Ok Rehab: Help For Addiction Help for Addiction – OK Rehab
