The diversity of seizures related to alcohol use. A study of consecutive patients

The aim of this study was to investigate the influence of hazardous alcohol drinking on the occurrence of epileptic seizures, the semiology of such se izures, and the extent of the problem. A consecutive sample of 142 acute se izure patients (78 male and 64 female, mean age 46 (16-79) years) was studi ed. Control groups were 185 consecutive sciatica patients and 254 healthy i ndividuals. Subjects with a hazardous alcohol drinking level were identifie d by a score >8 in the Alcohol Use Disorders Identification Test (AUDIT). S eizures in AUDIT-positive individuals occurring within 72 h of the last dri nk were considered to be related to alcohol withdrawal. Generalized or part ial onset seizures were classified on the basis of history, electroencephal ographic (EEG) and neuroradiological findings. Thirty-five percent of seizu re patients were AUDIT-positive, whereas conversely 27% were abstainers. Tw o-thirds of AUDIT-positive seizure patients met the criteria for withdrawal seizures. Indications of partial onset seizures were found in 25 (51%) of AUDIT-positive patients, all secondarily generalized seizures. Sixty percen t of generalized onset seizure patients were AUDIT-positive. In conclusion, seizure patients included significantly more AUDIT-positive subjects, as w ell as abstainers, than healthy Norwegian controls and consecutive sciatica patients from our hospital. Partial onset seizures are more frequent among hazardous drinkers than hitherto recognized. A generalized onset seizure i n adults warrants a high suspicion of alcohol as a provoking factor. Routin e screening of acute seizure admissions with the Alcohol Use Disorders Iden tification Test is recommended. fur J Neurol 6:697-703 (C) 1999 Lippincott Williams & Wilkins.