Can alcohol withdrawal cause seizures?

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Can alcohol withdrawal cause seizures?

Alcohol withdrawal can cause seizures. It is a common symptom among people who are chronic drinkers. If you are a heavy drinker and have been taking alcohol for a long time, if you decide to stop suddenly, you are likely to experience alcohol related seizures.

Aside from alcohol related seizures, there's also alcohol induced epilepsy. The latter occurs when a person struggling with alcohol dependence experiences seizures, yet they have no previous history of epilepsy. 

The relationship between alcohol and seizures is complex and multifaceted [1]. The seizures usually occur 6-48 hours after you stop drinking.

Alcohol affects the brain in several ways leading to alcohol induced seizure. One of the ways that alcohol use affects the brain is by disrupting the nervous system. 

Prolonged alcohol consumption triggers the central nervous system to build a tolerance for the drug. Alcohol suppresses glutamate receptors.  

Thus, when the person suddenly stops taking alcohol, the brain tries to regain its equilibrium before alcohol use, which leads to seizures. 

It's important to note that alcohol withdrawal is different for every individual. The effects of alcohol range from mild to severe withdrawal symptoms. 

During the first 6-24 hours after you stop drinking, you may experience minor withdrawal symptoms such as: 

  • Anxiety 
  • Headaches 
  • Palpitations 
  • Tremor 
  • Diaphoresis (excessive sweating) 
  • Tachycardia (rapid heart rate) 

Within 24 to 36 hours after your last drink, you may experience alcohol hallucinations (visual or tactile). Some patients describe these hallucinations as feeling like bugs crawling on your body or under the skin [2]. 

The alcohol withdrawal seizures tend to be brief with a short postictal phase. Prolonged seizures are not typical of alcohol withdrawal and should prompt the medical practitioner to look into other factors that may cause prolonged seizure activity. 

When you experience seizures, you are likely to develop DT (delirium tremens).

DT, or commonly known as the DTs, is a severe form of alcohol withdrawal symptoms. It occurs 3 to 5 days after your last drink and can be life threatening. 

The symptoms of DT include: 

  • Severe hypertension 
  • Heavy sweating 
  • Seizures 
  • Uncontrollable tremors 
  • Heart racing, irregular heartbeat 
  • Severe hyperthermia 
  • Severe disorientation, confusion, and hallucinations 
  • Coma and death 

DT is most common among: 

  • Heavy long-term drinkers 
  • People who have gone through alcohol withdrawal before and relapsed 
  • People with a history of seizures 
  • Young, Caucasian men [3]. 

People with epilepsy are warned about alcohol intake. A drink or two may not worsen their condition.

However, binge drinking, and alcohol abuse can lead to status epilepticus, which is a life-threatening and potentially fatal condition. 

According to the Epilepsy Foundation, small amounts of alcohol don't alter the amount of seizure medicines in your bloodstream.

Still, seizure medicines can lower your tolerance for alcohol. Consequently, you are likely to get drunk faster.  

Furthermore, you are more at risk of rapid intoxication because of the side effects of seizure medicines. If you are sensitive to both alcohol and seizure medicines, the combination may be worse for you. 

There are studies that associate chronic alcoholism or alcohol abuse with the development of epilepsy in some people.

For instance, a study by Andriy V. Samokhvalov, Hyacinth Irving, and others showed that alcohol could trigger the onset of epilepsy [4].  

The issue, however, is the causal factors leading to epilepsy remain unclear. This study theorizes that factors such as head traumas, hypoxia, and the kindling effects of alcohol may contribute to the onset of epilepsy. 

Other studies suggest that repeated alcohol withdrawal seizures may excite the brain more.

As a result, people who have experienced seizures due to binge drinking may begin to experience unprovoked epilepsy seizures regardless of alcohol use [5]. 

Also, some studies suggest some people may have a genetic predisposition to developing alcohol withdrawal seizures [6]. 

The Epilepsy Foundation reports that long-term alcohol abuse can increase a person's risk of developing epilepsy. 

If you have seizures or epilepsy, it is advisable that you: 

  • Avoid binge drinking 
  • Get help if you struggle with alcohol abuse 
  • Go for medical assistance to detox 

Alcohol withdrawal seizures are somewhat different from epilepsy seizures. In most instances, the seizures make epilepsy worse.

Withdrawal seizures are likely to occur among people who have taken alcohol for a long time. 

A study by Hayley C. Gorton, Roger T. Webb, Rosa Parisi, and others shows that people with epilepsy are at risk of dying from an alcohol-specific cause, unlike those without the disorder [7].  

The study states that people with epilepsy are five times more likely to die from alcohol-specific causes than those without the condition. 

When a person suddenly stops drinking or reduces large amounts of their alcohol intake over a short time, they are likely to experience alcohol related seizures.

It's important to note that this can happen to people with or without epilepsy. 

The withdrawal seizures are a result of the alcohol withdrawal and are not due to epilepsy itself. 

There is no limit to the amount that you have to drink to experience an alcohol withdrawal seizure. As a general rule, the more you drink, the higher your chances of developing withdrawal seizures. 

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Alcohol seizures symptoms 

Alcohol seizure symptoms include a loss of consciousness. If you're sleeping, you feel slowly taking time to wake up or regain consciousness.  

If you are awake during an alcohol withdrawal seizure, you may experience repetitive, uncontrolled movements on parts of your body or your entire body.  

Before the seizure, you may have visual disruptions or a change in smell, taste, or sound due to changes in brain activity. 

Seizures are a type of electrical brain disturbance that can lead to mild to severe symptoms. The symptoms can also last for a few seconds to several minutes, depending on the type of seizure. 

The two main types of seizures are: 

a). Generalized seizures 

This type of seizure affects both parts of the brain and includes absence or petit mal seizure. The symptom of an absence seizure is that the individual stares blankly into space for a few seconds or blinking quickly.  

Other symptoms include tonic-clonic (or grand mal) seizures characterized by loss of consciousness, convulsions, or violent muscle contractions that make you fall to the ground.  

Some people experience alcohol withdrawal seizures that make them scream or experience loss of bladder control. Tonic clonic is the most common type of alcohol related seizure. 

b). Focal or partial seizures 

This alcohol withdrawal seizure affects one side of the brain. It occurs due to trauma or any type of focal brain injury (an injury that occurs in one brain region).  

The injury leaves a scar, such as a stroke or meningitis. 

It can also cause mild to severe symptoms such as twitching, changes in sensation (such as smell or taste), lack of responsiveness, confusion, abdominal pain, rapid heart rate or pulse, contractions on just one side of the body, unusual head or eye movements, numbness, tingling, or the feeling that something is crawling under your skin. 

There are instances where the focal seizures can turn into generalized seizures.

The seizures appear 6 to 48 hours after you stop drinking. As pointed out earlier, this symptom is likely to occur in people with chronic alcohol use or alcohol abuse conditions [8]. 

The seizures can appear in single or brief clusters that are typically categorized as tonic-clonic nonfocal. Alcohol withdrawal seizures are a strong indicator that the individual's withdrawal symptoms are likely to become severe.  

Furthermore, withdrawal seizures are associated with substantial morbidity and mortality [9]. 

In a study conducted by Michael Hammerle, Leyli Ghaeni, and others, the researchers assessed alcohol consumption with alcohol-related seizures in patients with epilepsy.  

The study included 310 patients, out of which 204 consumed alcohols within the past 12 months. 37 out of the 204 patients experienced seizure worsening due to alcohol consumption [10].  

The 37 patients consumed alcohol in large amounts. The patients took at least 7 standard drinks, about 1.4L of beer or 0.7L of wine.

In the study, 95% of the cases of alcohol withdrawal seizures occurred within 12 hours after the patients stopped drinking. 

Several studies reveal that a significant number of patients who exhibit withdrawal seizures have seizure etiology such as a traumatic brain injury, epilepsy, or cerebrovascular accident, etc. [11].  

Alcohol use is connected to traumatic brain injury. Studies show that 30% to 50% of patients treated for traumatic brain injury were intoxicated at the time of injury. Binge drinking is also associated with major brain trauma [12]. 

When a person with epilepsy mixes alcohol with seizure medicines, they increase their risk of seizures. Some people state that mixing alcohol with anti-epileptic drugs (AEDs) made them get drunk quicker.  

The alcohol can lead you to have withdrawal seizures within seven to 72 hours when you stop drinking. In some people, the seizures can occur immediately once you stop taking alcohol. 

It's important not to stop taking AEDs because you want to take alcohol. You increase your chances of getting seizures when you forgo your medication [13]. 

If you have epilepsy, some of the risk factors you should be aware of include: 

a). Effects of the hangover  

Most people with epilepsy have their first seizure when they are a hangover. One reason for this is because when a person is a hangover, their brain is dehydrated, and the alcohol level drops. 

b). Sleep deprivation  

Alcohol affects your body's sleep pattern. This disruption can trigger a seizure in some people with epilepsy. 

c). Interaction with the AEDs  

The alcohol and seizure medication may interact in ways that trigger a seizure. This Interaction also negatively affects your health in many ways.  

For example, the seizure medication known as Keppra combined with alcohol increases your chances of developing liver problems.

Alcohol also affects how certain medications are released in the bloodstream, for instance, medications such as Trokendi XR. 

Some medications have warnings against alcohol use. Also, it is important to talk to your doctor before taking alcohol with certain seizure medicines.  

In some people with epilepsy, the seizures from excessive drinking can last as long as three days after they stop drinking. 

Some seizure medications such as lorazepam, diazepam (Valium), clonazepam (Klonopin) is classified as benzodiazepines.

You should not mix alcohol with these drugs as they significantly affect the central nervous system. 

d). Whether the seizures are controlled or not  

People whose seizures are controlled by drugs, or a medical device may have fewer problems when taking alcohol. However, if your seizures are not controlled, the alcohol use may make it worse. 

e). Alcohol trigger seizures 

Whether you have epilepsy or not, heavy drinking increases the risk of seizures. If the seizure lasts more than 5 minutes, it is referred to as status epilepticus. Such seizures are more life threatening than shorter seizures. 

If you are alcohol dependent and would like to stop drinking, it would be best if you seek addiction treatment to reduce the risk of seizures. This is important, especially if you are chronically alcohol dependent.

If you are not alcohol dependent, you are still at risk of developing withdrawal symptoms, including withdrawal seizures, if you drink heavily over a long period. 

When a person goes to a hospital due to a withdrawal seizure, they are likely to have some blood tests, heart tracing (ECG), x-ray, and in some instances, a brain scan.

Whether you have epilepsy or not, withdrawal seizures come with other symptoms.

These symptoms include: 

  • Tremor 
  • Sweating 
  • Anxiety/irritability 
  • Feeling nausea/vomiting 
  • Headache 
  • Sleep disturbance 
  • Confusion 
  • Marked tremor 
  • Hallucinations 
  • Sensitivity around sounds. 
  • Seizures (fits). 

People who have experienced withdrawal seizures in the past are likely to have another seizure in the future if they binge drink or change their alcohol patterns. 

It is possible to enjoy moderate amounts of alcohol intake without becoming addicted. However, heavy drinkers are likely to develop alcohol use disorder.  

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), alcohol use disorder is characterized by 11 key symptoms [14]: 

  • An individual takes the alcohol in large amounts over a longer period than intended. 
  • There's a persistent desire to cut down on alcohol use, and previous efforts to do so have been unsuccessful. 
  • Much time is spent in activities geared to get the alcohol or recover from its effects. 
  • The person suffers from a craving or a strong urge to use alcohol. 
  • Recurring alcohol intake impedes the person's ability to engage in daily obligations, e.g., work, school, or home. 
  • The person gives up important social, occupational, or recreational activities due to alcohol consumption. 
  • They engage in alcohol consumption in hazardous situations. 
  • The person persists in alcohol intake even though they are aware that they have a persistent physical or psychological problem that may have been exacerbated by alcohol. 
  • The person develops a tolerance. This is defined as the desire to take in more alcohol to achieve intoxication or the desired effect. It takes more alcohol than it did before to achieve the desired intoxication. 
  • The individual experiences withdrawal symptoms when they stop drinking. 

People suffering from alcohol use disorder will experience alcohol withdrawal symptoms when they stop heavy alcohol use. In some cases, the withdrawal leads to seizures but not in all instances. 

Why does alcohol detox cause seizures? 

Alcohol detox causes seizures because when you suddenly stop drinking, the brain removes the alcohol toxin and regains its normal functioning before alcohol use.

This symptom is likely to occur in people who suffer from alcohol use disorder. 

Extensive studies are showing that alcohol affects the brain's neurobiology. Alcohol causes intoxication through its effects on major neurotransmitters, including GABA and N-methyl-D-aspartate (NMDA) receptors.  

The alcohol binds to the GABA receptors, mimics it in the brain, thereby inhibiting neuronal signalling [15].

The ethanol modifies the nervous system's receptors and ion channels, causing significant alterations in almost every neurotransmitter-signalling system.  

Alcohol affects the major excitatory neurotransmitter known as glutamate. It releases inhibitors such as dopamine and serotonin, which make the person feel pleasure when they drink more. 

The effects of alcohol in the nervous system range from short-term to long-term. In the long term, the body develops a tolerance to over drinking.  

Withdrawal seizures are evidence that heavy drinking has significantly altered the nervous system. Detox is the body's way of trying to get rid of the toxins.  

Studies also show that the withdrawal seizures are due to withdrawal-induced cellular events, for instance, rapid increases in alpha4 subunit-containing GABA(A) receptors that are mainly inhibitory neurotransmitters [16]. 

Several studies associate alcohol withdrawal syndrome, including delirium tremens and seizures, with the alcohol's effect on the GABA and N-methyl-d-aspartate (NMDA) receptors. 

Since alcohol is a depressant, when you stop drinking, the brain gets into a hyper-excited state. It goes into a rebound activation as it tries to boost those receptors. 

Homocysteine levels increase when one takes alcohol. This is an essential amino acid that helps your body create proteins. When you quit drinking, the body further increases its production of homocysteine.  

This change is viewed as a risk factor for alcohol withdrawal syndrome and a screening tool [17]. 

Generalized tonic clonic seizures are the most common type of seizure during alcohol withdrawal. People who take alcohol daily are at risk of getting these seizures.

However, people who binge drink are also at risk of developing withdrawal seizures. 

Focal seizures are less common and are associated with other factors at play other than alcohol. Epileptic patients are prone to focal seizures (focal epilepsy).  

In such instances, alcohol is associated with loss of seizure control [18]. Several studies show that in epileptic patients, alcohol alone should not be blamed. 

A person who experiences withdrawal seizures needs clinical care. This is because the withdrawal seizures can progress to delirium tremens, which puts you at a greater risk.

Since seizures are a severe withdrawal symptom, it is advisable to seek clinical experience to manage it better. 

The main standard of treatment for alcohol abuse patients with repeated seizures is the use of benzodiazepines (e.g., diazepam, chlordiazepoxide, and lorazepam) [18]. 

The medication is believed to be effective in preventing the recurrence of alcohol related seizures. 

Status epilepticus, which is the experience of having more than one seizure in five minutes, can lead to permanent brain damage or death if left unchecked.  

This symptom occurs in patients with other treatable conditions such as head trauma, meningitis, low blood sugar levels (hypoglycemia), hyponatremia (low sodium levels), and other drugs ingested [18]. 

Can alcohol detox cause hallucinations? 

Alcohol detox can cause hallucinations. This symptom is not common in everyone, but people with chronic alcohol addiction risk experiencing it.

People with a long history of drinking are likely to experience this unpleasant alcohol withdrawal symptom. 

There are types of alcohol related hallucinations. For instance, delirium tremens are associated with auditory, visual, and tactile hallucinations.  

The person experiences disorientation and feels agitated. They also experience delusions and auditory hallucinations. What makes the alcohol hallucinations unique is that the person is fully conscious.  

But they may struggle to tell the difference between the hallucinations and real life. Paranoid symptoms and fear almost always accompany the hallucinations.

They feel as if a third voice is commanding them to do something bad. 

Having a medical practitioner around helps make the experience less traumatic. 

a). Auditory hallucinations 

They are characterized by hearing voices or a voice. 

 The experience is different for each person. Others describe hearing the voice from another room. In others, the voice may tell them that they need another drink. 

b). Visual hallucinations 

The patient sees things that no one else can see. In most cases, the hallucinations can be frightening. 

c). Tactile hallucinations 

Most recovering alcoholics state that tactile hallucinations are the worst kind to experience.

You feel like something is on your skin or under your skin, e.g., bugs crawling under your skin. Others report feeling a burning sensation or an itch that won't go away. 

The onset of hallucinations varies depending on each individual. In some people who drink heavily, the symptoms may appear immediately after the last drink.  

In others, the symptom may appear shortly after periods of heavy alcohol consumption. The symptoms may last up to 24 hours at most, but there are instances where they can persist for days or weeks. 

The cause of hallucinations remains unclear. Left unchecked, this symptom can lead to neurological disorders. Most experts believe that this symptom is due to the effect of alcohol in the body, particularly the nervous system.  

Heavy alcohol use disrupts the neuronal activity of the nervous system. It is not unlikely that the ability of alcohol to block NMDA receptors triggers hallucinations [19].  

Other factors that may trigger hallucinations are a poor diet during the detox process. Being unwell or sustaining a health injury also means that the person is susceptible to hallucinations. 

Some people may experience chronic hallucinosis. This symptom is primarily auditory and may appear during or shortly after periods of heavy drinking. It may also involve delusions and mood disturbances.  

The symptoms may persist for a short period or progress to a chronic, long-lasting form that mimics schizophrenia. 

It's important to remember that not everyone will experience hallucinations. Some people opt to continue with their compulsive drinking out of fear of the detox withdrawal symptoms.

However, if you or your loved one is a heavy drinker, it would be best if they sought treatment at a medical facility or a rehab centre. 

There are prompt treatment options available for treating chronic alcohol use. Detox symptoms such as alcohol withdrawal seizures and hallucinations are treated using medications.  

For hallucinations, the medical practitioner may administer medications such as Diazepam, Clonazepam, Lorazepam, Alprazolam. 

Final Remark 

Chronic alcohol abuse is associated with unpleasant alcohol withdrawal symptoms. These symptoms may appear immediately after your last drink or during the alcohol withdrawal process.  

In some cases, the person may experience alcohol withdrawal seizures or other unpleasant symptoms such as hallucinations. 

People with epilepsy are also likely to experience seizures, especially if they engage in heavy drinking.

The Epilepsy Foundation states that people with epilepsy can have one or two drinks a day without worsening their seizures or triggering changes that increase seizure activity [20]. 

Still, when one stops drinking suddenly, they are likely to trigger seizures whether they have epilepsy or not. In rare cases, heavy drinking can lead to the development of alcohol related epilepsy [21]. 

Chronic drinkers or people suffering from alcohol use disorder are advised to seek treatment. Medical assistance will not only prevent relapse but also help make the alcohol withdrawal process more manageable. 

When you abuse alcohol, you negatively alter the neurological mechanisms of the nervous system. You also put your body at risk of developing other complications. 

Don't let the fear of withdrawal symptoms keep you from seeking detox. Get help today and give yourself the chance to lead a healthy, fulfilling life. 

Abbeycare Pricing Bot

Last Updated: November 8, 2021

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.