Physical dependency on alcohol develops following a sustained period of daily heavy drinking. This can result in the development of an alcohol withdrawal syndrome, with such symptoms as tremulousness (the shakes), sweating. In more severe cases withdrawal seizures (or fits) may occur. The more severe withdrawal symptoms occur between 24 48 hours after stopping drinking, though they can occur later than this.
Alcohol withdrawal seizures usually occur in physically dependant individuals when there is a cessation of alcohol or a sudden and significant reduction in their blood alcohol levels. Such cessation or rapid reductions in alcohol consumption may be due to factors such as ill health (and an inability to drink); lack of money; a rushed attempt to ‘self detox’. Alcohol withdrawal seizures are more likely in those with a previous history of such seizures.
Alcohol withdrawal seizures are similar to the grand seizures seen with epilepsy (also known as tonic-or generalised seizures). Experiencing a withdrawal seizure however does not necessarily mean that someone has epilepsy.
Seizures may involve a loss of consciousness of several minutes, muscle contraction and rigidity (lasting 15 or 20 seconds), and then violent muscle contraction and relaxation lasting for 1 or 2 minutes. Other features may include biting of the cheek or tongue, clenched teeth and incontinence. After the seizure there may be some memory impairment, drowsiness, brief confusion and headache. Breathing usually returns to normal soon after the end of the seizure.
First aid during such a seizure involves removing sharp/hard objects from the area; providing a cushion (etc) to protect the head; loosening clothing around the neck; positioning the head to prevent the tongue from obstructing the airway and observing for difficulties. Following the convulsion the person should be placed in the recovery position (i.e. laid on one side) to aid breathing and reduce the risk of asphyxiation. It is also important to provide reassurance and monitor the person until consciousness is regained.
Do not restrain someone during a seizure, or to put anything in the person’s mouth or to force anything between his or her teeth. The person should not be moved unless they are in danger. Drinks should not be given until consciousness is fully regained.
Urgent medical attention is not always required following a withdrawal seizure, though may be needed if an injury occurs during the seizure.
If someone experiences multiple repeated seizures (Status epileptics) this may cause a severe lack of oxygen to the brain and is an emergency situation requiring immediate medical attention.
Some long-term heavy drinkers may develop epilepsy proper and will be prone to seizures independently of alcohol withdrawal. If they continue to drink heavily their epilepsy may be exacerbated, especially if they fail to comply with their anti-convulsant medication.