STATUS EPILEPTICUS RELATED TO ALCOHOL-ABUSE

We reviewed the case records of 249 adult patients with generalized co nvulsive status epilepticus (SE) examined at San Francisco General Hos pital between 1977 and 1989 and identified 27 patients (10.8%) in whom alcohol abuse was the only identifiable precipitating cause of SE. In 12 patients (44% of the study group), SE was the first presentation o f alcohol-related seizures. Seizures with focal features were observed in 11 patients (40.1%), but there was little correlation with localiz ed computed tomography (CT) or EEG abnormalities. SE was controlled wi th phenytoin (PHT), with or without a benzodiazepine (BZD), in 18 pati ents (66.7%). Twenty-two patients (81.5%) were discharged with no new neurologic deficits, but time to recovery of baseline mental status wa s prolonged (>12 h) in 24 patients. With regard to alcohol abuse histo ry, study patients did not differ from a comparison group with isolate d alcohol withdrawal seizures. The results indicate that alcohol abuse is a common cause of SE and that SE may be the first presentation of alcohol-related seizures. Furthermore, the outcome of patients with al cohol-related SE compares favorably with that of patients with SE due to other causes, but recovery of these patients may be complicated by a prolonged postictal state.