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Seizures in Critical Care pp 283–306Cite as

Alcohol-Related Seizures in the Intensive Care Unit

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Abstract

Alcohol abuse is a common cause of seizures resulting in admission to the intensive care unit. The cause of the alcohol-related seizures (ARS) is usually abstinence in a chronic alcoholic, although some patients may still have detectable levels of alcohol in their blood. ARS generally occur between 7 and 48 h after abstinence. Approximately half the patients presenting with ARS will have recurrent seizures (usually 2–4) within a vulnerable 6 h period following the initial ARS. Although patients with ARS rarely enter status epilepticus, alcohol withdrawal is a common contributing factor in many cases of status epilepticus. Evaluation involves searching for a focal cause of the seizure as well as looking for comorbid conditions which may complicate the management of chronic alcohol abusers, including delirium tremens. Treatment of ARS is similar to general management of alcohol withdrawal, with benzodiazepines being the mainstay of treatment. Treatment of alcohol-related status epilepticus is similar to that of other causes of status epilepticus. Phenytoin is not indicated for treatment of ARS unless the patient enters status epilepticus.

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  1. Sleep Disorders Center, NorthStar Medical Specialists, Bellingham, WA, USA

    Zachary Webb (Medical Director)

  2. Neuro-Intensive Care Unit, Senior Staff Neurology & Neurosurgery, Henry Ford Hospital, Detroit, MI, USA

    Panayiotis Varelas (Director, Associate Professor of Neurology)

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  1. Dept. Neurology, Henry Ford Hospital, W. Grand Blvd. 2799 , Detroit, 48202-2689, U.S.A.

    Panayiotis Varelas

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Webb, Z., Varelas, P. (2010). Alcohol-Related Seizures in the Intensive Care Unit. In: Varelas, P. (eds) Seizures in Critical Care. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-532-3_12

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