Debate continues about the relationship of alcohol use/abuse and degeneration of the brain.
There seems to be no increased risk for epilepsy in persons who drink less than 50g of alcohol daily (about 2 drinks). Increased daily alcohol intake increases the risk for seizures. There is a 15- to 20-fold increase for persons who drink 200g or more of alcohol daily.
Studies
1 show that persons who regularly consume large amounts of alcohol have both a risk of seizures upon the abrupt reduction or discontinuation of alcohol consumption (
withdrawal seizures), and a 3-fold increase in the risk for epilepsy.
Based on surveys of volume and frequency of consumption, approximately 10 to 20% of the adult population (over age 10) can be considered to "drink heavily". Approximately 10% of this population will have seizures; 4.5% of this population will be diagnosed with epilepsy by the age of 80.
Studies show that between 10 and 25% of newly diagnosed cases of epilepsy in adults may show chronic alcohol abuse as a risk factor.
Withdrawal from alcohol use is a factor in about 30% of persons experiencing alcohol-related seizures.
2
In addition to the direct effects of alcohol consumption and withdrawal from its use, there are other associated risks with alcohol abuse, including acquired post-traumatic epilepsy (from head injuries sustained in accidents), meningitis, neoplasms, strokes, hypoglycemia and hyponatremia.
Alcohol & AEDs
Alcohol will increase the sedative effect of antiepileptic drugs (AEDs). AEDs may weaken one's tolerance to alcohol, making it easier to become intoxicated.
Alcohol can affect the rate of absorption of one's AEDs.
- The effects of carbamazepine and phenobarbital are reduced when alcohol is ingested.
- The mixture of divalproex sodium with alcohol causes severe depression of the central nervous system.
- Alcohol will upset the blood serum level of phenytoin: acute alcohol intake will increase the blood serum level, while chronic alcohol intake will decrease blood serum levels.
When excessive consumption of alcohol leads to missed medications, particularly if the omission is combined with inadequate sleep, irregular meals and emotional turmoil, seizures are almost certain to follow.
Alcohol & DrivingThe
Canadian Medical Association (CMA) states that "alcohol abuse is the highest risk factor for motor vehicle-related collisions and injury."
Chronic alcohol abuse is a serious medical disability, and a chronic alcohol abuser should not drive any type of motor vehicle. Further, the CMA suggests that "Patients with a diagnosis of alcohol dependence, including those with alcohol withdrawal seizures, should not be allowed to drive any type of motor vehicle. These patients
must complete a recognized rehabilitation program for substance dependence and remain alcohol free and seizure free for
12 months before recommencing driving."
Alcohol & Other Chronic Medical ConditionsWell-known clinical conditions such as liver disorders, pancreatitis, depression, chronic gastritis and vitamin deficiency are known to be associated with alcoholism.
References
1. SKC Ng, WA Hauser, JCM Brust & M Susser. Alcohol consumption and the risk of new onset seizures. New England Journal of Medicine. 1988; 319:666-673.
2. BS Koppel, M Daras, AJ Tuchman, WA Hauser, TA Pedley. The relation between alcohol and seizures in a city hospital population. Journal of Epilepsy. 1992; 5:31-37.
Sources
