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Late-onset seizures in alcohol withdrawal
1Substance Abuse Treatment Program, Veterans Affairs Medical Center, Manchester, NH 03104, USA.
Alcoholism, Clinical and Experimental Research
|June 1, 1995
Summary
Alcohol withdrawal seizures still occur at a low rate with short-acting benzodiazepines. These seizures are linked to stopping oxazepam, not alcohol cessation, in patients undergoing detoxification.
Area of Science:
- Neurology
- Addiction Medicine
- Pharmacology
Background:
- Alcohol withdrawal syndrome (AWS) is a common and potentially dangerous condition.
- Benzodiazepines are standard treatment for AWS, but seizure risk persists.
- Understanding seizure characteristics in treated patients is crucial for optimizing care.
Purpose of the Study:
- To characterize clinical features of alcohol withdrawal seizures in patients receiving a standardized short-acting benzodiazepine protocol.
- To investigate the timing and potential triggers of seizures during detoxification.
Main Methods:
- Prospective identification of grand mal seizures in 1044 inpatients undergoing alcohol detoxification.
- Standardized 72-hour oxazepam taper with additional doses as needed for withdrawal symptoms.
- Comparison of seizure group characteristics with a control group.
Main Results:
- An overall seizure rate of 1.1% was observed (11 seizures).
- Seizures occurred a mean of 122 hours post-admission, peaking 12-48 hours after the last oxazepam dose.
- Patients with seizures were older, had prior withdrawal seizures, and experienced more severe withdrawal.
Conclusions:
- Short-acting benzodiazepines like oxazepam do not eliminate the risk of alcohol withdrawal seizures.
- Seizures in this cohort were associated with oxazepam cessation rather than alcohol cessation.
- Clinical presentation differs from untreated alcohol withdrawal seizures.