Alcohol Withdrawal Seizures: Causes, Symptoms, and Treatment

Medical tapering using benzodiazepines Alcohol Use Disorder is safer, more consistent, and scientifically proven to prevent seizures. Completing a full, medically supported detox followed by structured aftercare is your best defense against long-term neurological damage. Home detox is only safe if you are screened as low-to-moderate risk and have a structured medical plan in place. However, they must be used under strict medical supervision to avoid dependency. At The Springboard Center, our medical team carefully monitors benzodiazepine use to ensure patient safety. Verify your insurance today – treatment could be more affordable than you think.

Co-Occurring Disorder Treatment

Your healthcare provider will recommend and encourage treatment for alcohol use disorder. Symptoms of alcohol withdrawal tend to peak 24 to 72 hours after your last drink. However, about 60% of people who have one withdrawal seizure will have additional seizures during the same withdrawal episode if not medically treated. Kim et al.42 have demonstrated that one‐third of patients with a history and presence of ARS developed DT during withdrawal syndrome. The etiology of ARS and DT is complex and involves various distinct demographic and clinical characteristics.

BENZODIAZEPINES

If certain medications decrease the kindling effect, they may become preferred agents. Alcohol enhances the effect of GABA on GABA-A neuroreceptors, resulting in decreased overall brain excitability. Chronic exposure to alcohol results in a compensatory decrease of GABA-A neuroreceptor response to GABA, evidenced by increasing tolerance of the effects of alcohol. It’s also important to note that delirium tremens can be life-threatening.

The risk of seizure recurrence within 6 to 12 hours is estimated at between 13 and 24 per cent in untreated patients. These programs often utilize specific medications to alleviate withdrawal discomfort and prevent serious events like seizures. For instance, benzodiazepines are sometimes administered in a controlled, tapering manner to prevent alcohol withdrawal seizures.

Ketamine Withdrawal Symptoms, Timelines, And Recovery Support

Patients in the study received 800 mg of carbamazepine on the first day, with the dosage tapered to 200 mg by the fifth day. Carbamazepine (Tegretol) also appears to decrease the craving for alcohol after withdrawal. Although carbamazepine is used extensively in Europe, its use in the United States has been limited by lack of sufficient evidence that it prevents seizures and delirium. Alcohol withdrawal delirium, or delirium tremens, is characterized by clouding of consciousness and delirium. In a meta-analysis of controlled trials for prevention of alcohol withdrawal seizures, a highly significant risk reduction for seizures with benzodiazepines compared to placebo was demonstrated (20).

Alcohol withdrawal seizures typically occur 6 to 48 hours after discontinuation of alcohol consumption and are usually generalized tonic–clonic seizures, although partial seizures also occur (7,8). It is most important that the detox is done at a treatment center to decrease the risk of suffering from Alcohol Withdrawal Seizures. If the patient’s hands start to shake after a period of going without drinking alcohol, then the risk of having alcohol withdrawal seizures is very high. Detoxification at home should be strictly avoided and should always be done under medical supervision to prevent Alcohol Withdrawal Seizures. If a person is detoxing at home and starts feeling tremors, which often develop around 6 to 10 hours after the last drink, then it is important to admit the patient into a detox facility or hospital immediately.

Ethanol, the active ingredient in alcoholic beverages, acts as a CNS depressant. They pose risks of physical injury, progression to life-threatening conditions like delirium tremens (DTs), and even death if untreated. These seizures are caused by specific changes in your body and brain as you adjust to life without alcohol. The Springboard Center provides lasting solutions and the support you need for your journey to recovery. Many individuals benefit from continued participation in 12-step groups, peer support networks or aftercare programs to maintain accountability and find fellowship on the path to sobriety. Moreover, family therapy offers loved ones an opportunity to learn healthy boundaries, cope with the emotional toll of a family member’s addiction and strengthen their own resiliency.

Clinical Features

Even if you are no longer dependent on alcohol, you may have a compulsion to drink that’s hard to control.
The relevance of this mechanism is highlighted by the fact that NMDA-receptor antagonists are highly effective anticonvulsants in animal models of alcohol withdrawal seizures (59).
Therefore, an abnormal EEG suggests that the seizure may not have been caused exclusively by alcohol withdrawal (60).
Studies have found that people who experience seizures triggered by binge drinking can, in the future, start experiencing unprovoked seizures even in the absence of alcohol intake.
Alcohol withdrawal seizures typically occur as blood alcohol reaches zero, up to 24 hours after alcohol cessation or with abrupt reduction in intake (42).

Benzodiazepines are first-line therapy for moderate to severe symptoms, with carbamazepine and gabapentin as potential adjunctive or alternative therapies. Physicians should monitor outpatients with alcohol withdrawal syndrome daily for up to five days after their last drink to verify symptom improvement and to evaluate the need for additional treatment. Primary care physicians should offer to initiate long-term treatment for alcohol use disorder, including pharmacotherapy, in addition to withdrawal management.

Likewise, high risk can develop from a family history of seizure disorders.
But treatment varies based on the severity of alcohol withdrawal and the likelihood that it could progress to severe or complicated withdrawal.
About 1 in 10 heavy drinkers who quit cold turkey end up convulsing on the floor.

However, our results may be important for better understanding the interplay between the occurrence of ARS, the development of DT, and the severity of AWS. Additionally, in our follow‐up study, the severity of AWS was measured with one tool and without vital signs. Moreover, a small number of patients were examined during a relatively short 1‐year period. In the future, a more detailed assessment of the severity of AWS will be needed. Our present data support and extend previous observations2, 3 by showing that about 20% of inpatient admissions are presented with a complicated form of AWS, and the withdrawal seizures percentage of ARS was about 10% in the total sample.

Nutritional Therapy

Many detox programs use the CIWA protocol, a clinical tool to assess and manage alcohol withdrawal symptoms effectively. This includes regular checks of vital signs, neurological assessments, and immediate intervention if complications arise. The good news is that alcohol withdrawal seizures are preventable with the right treatment and care. One of the primary triggers of alcohol withdrawal seizures is the abrupt cessation of alcohol consumption. Alcohol itself also would be expected to improve withdrawal symptoms, and alcoholic patients know that alcohol consumption can relieve their symptoms. Alcohol should not be used, however, to treat withdrawal for several reasons.