Epidemiological profile of epileptic seizures related to alcohol withdrawal syndrome
DOI:
https://doi.org/10.34024/rnc.2023.v31.14137Keywords:
Alcohol Withdrawal, Seizures, EpidemiologyAbstract
Introduction. Alcohol withdrawal syndrome (AWS) can occur in about half of patients with alcohol use disorder who abruptly reduce or cease consumption of this substance. Epileptic seizures are one of the possible manifestations. Objective. Evaluate epidemiological data, clinical characteristics, length of hospital stay and recurrence of emergency medical care between patients with alcohol withdrawal-related epileptic seizures. Method. This is a retrospective observational study, with data collection from medical records of patients treated for epileptic seizures caused by AWS in a public hospital in Minas Gerais within a year. Inferential statistical association between nominal variables was assessed by cross-tabulation with the chi-square test. Results. 45 patients were included in the study. The most prevalent age group was 35 to 45 years (37.7%). In 46.6%, it was described a previous diagnosis of epilepsy. There was an association between the previous diagnosis of epilepsy and the presence of epileptic seizures (p<0.001). The type of seizure was generalized tonic-clonic since the onset in 92% of cases. 78% had seizures up to 48 hours after the last alcohol consumption. The rate of recurrence at the emergency department during the year was 31%. Conclusion. AWS-related epileptic seizures predominantly affect young men and are associated with a high recurrence rate of need of emergency hospital care, being a complex public health problem. These data point to the need to strengthen strategies for primary prevention.
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References
Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet 2009;373:2223-33. https://doi.org/10.1016/S0140-6736(09)60746-7
Guimarães VVFA, Stopa SR, César CLG. Alcohol abuse and dependence in adults in the State of São Paulo, Brazil. Rev Bras Epidemiol 2010;13:314-25. https://doi.org/10.1590/S1415-790X2010000200013
Beghi E, Carpio A, Forsgren L, Hesdorffer DC, Malmgren K, Sander JW, et al. Recommendation for a definition of acute symptomatic seizure. Epilepsia 2010;51:671-5. https://doi.org/10.1111/j.1528-1167.2009.02285.x
Ferlisi M, Shorvon S. Seizure precipitants (triggering factors) in patients with epilepsy. Epilepsy Behav 2014;33:101-5. https://doi.org/10.1016/j.yebeh.2014.02.019
Hillbom M, Pieninkeroinen I, Leone M. Seizures in alcohol-dependent patients: epidemiology, pathophysiology and management. CNS Drugs 2003;17:1013-30. https://doi.org/10.2165/00023210-200317140-00002
Goodson CM, Clark BJ, Douglas IS. Predictors of severe alcohol withdrawal syndrome: a systematic review and meta-analysis. Alcohol Clin Exp Res 2014;38:2664-77. https://doi.org/10.1111/acer.12529
Leach JP, Mohanraj R, Borland W. Alcohol and drugs in epilepsy: pathophysiology, presentation, possibilities, and prevention. Epilepsia 2012;53(Suppl 4):48-57. https://doi.org/10.1111/j.1528-1167.2012.03613.x
Victor M, Brausch C. The role of abstinence in the genesis of alcoholic epilepsy. Epilepsia 1967;8:1-20. https://doi.org/10.1111/j.1528-1157.1967.tb03815.x
Carlson RW, Kumar NN, Wong-Mckinstry E, Ayyagari S, Puri N, Jackson FK, et al. Alcohol withdrawal syndrome. Crit Care Clin 2012;28:549-85. https://doi.org/10.1016/j.ccc.2012.07.004
Bayard M, McIntyre J, Hill KR, Woodside J, Jr. Alcohol withdrawal syndrome. Am Fam Physician 2004;69:1443-50. https://www.aafp.org/pubs/afp/issues/2004/0315/p1443.html
Wagman JA, Nabukalu D, Miller AP, Wawer MJ, Ssekubugu R, Nakowooya H, et al. Prevalence and correlates of men's and women's alcohol use in agrarian, trading and fishing communities in Rakai, Uganda. PLoS One 2020;15:e0240796. https://doi.org/10.1371/journal.pone.0240796
Waja T, Ebrahim J, Yohannis Z, Bedaso A. Prevalence of alcohol use disorders and associated factors among people with epilepsy attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Neuropsychiatr Dis Treat 2016;12:2989-96. https://doi.org/10.2147/NDT.S122296
Misra UK, Kalita J. Management of provoked seizure. Ann Indian Acad Neurol 2011;14:2-8. https://doi.org/10.2147/NDT.S122296
Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, Jansen FE, et al. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017;58:522-30. https://doi.org/10.1111/epi.13670
Sandeep P, Cherian A, Iype T, Chitra P, Suresh MK, Ajitha KC. Clinical profile of patients with nascent alcohol related seizures. Ann Indian Acad Neurol 2013;16:530-3. htpps://doi.org.br/10.4103/0972-2327.120454
Thijs RD, Surges R, O'Brien TJ, Sander JW. Epilepsy in adults. Lancet 2019;393:689-701. https://doi.org/10.1016/S0140-6736(18)32596-0
Gill JS, Shipley MJ, Tsementzis SA, Hornby RS, Gill SK, Hitchcock ER, et al. Alcohol consumption-a risk factor for hemorrhagic and non-hemorrhagic stroke. Am J Med 1991;90:489-97. https://doi.org/10.1016/0002-9343(91)80090-9
Weisberg LA. Alcoholic intracerebral hemorrhage. Stroke 1988;19:1565-9. https://doi.org/10.1161/01.STR.19.12.1565
Matz R. Lorazepam for the prevention of recurrent seizures related to alcohol. N Engl J Med 1999;341:609-10. https://doi.org/10.1056/NEJM199903253401203
Nidanews. Treatment Approaches for Drug Addiction DrugFacts | National Institute on Drug Abuse. 2019. https://nida.nih.gov/sites/default/files/drugfacts-treatmentapproaches.pdf
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Copyright (c) 2023 Jéssica Guimarães, Lígia Barros de Oliveira, Renato Souto de Vasconcelos, Pedro Henrique Souza Reis, Mauro Eduardo Jurno, Francisco de Assis Pinto Cabral Júnior Rabello
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Accepted 2023-03-09
Published 2023-03-30
