These observations have led to the view that alcohol withdrawal causes permanent epileptogenic changes in brain systems relevant to ethanol withdrawal seizures—a type of kindling phenomenon. Indeed, in accordance with the central role of the IC in triggering alcohol withdrawal why does alcohol withdrawal cause seizures seizures, multiple alcohol withdrawal episodes in rats facilitate the development of IC kindling (87,88). In animals, benzodiazepines have yielded variable effects, in some cases slowing withdrawal-induced kindling, and in other cases, causing paradoxical worsening (65,66,89).
This research suggests that repeated alcohol withdrawal seizures may make the brain more excitable. Thus, people who have experienced seizures provoked by binge drinking may begin to experience unprovoked epilepsy seizures regardless of alcohol use. The absolute best way to prevent or reduce the risk of alcohol withdrawal seizures is to enter a detox center. Individuals will differ in their tolerances to certain medications, and medical professionals will be able to determine the unique needs of each person.
Recently, however, it has been discovered that GABAA receptors containing the δ subunit, in particular α4β2δ (36) and α6β2δ (37) receptors, are exceptionally sensitive to ethanol. Because δ subunit–containing GABAA receptors have a highly specific regional distribution, the lack of uniformity in the experimental results is now understandable. Mody (39) has proposed that such δ subunit–containing GABAA receptors are located largely perisynaptically or extrasynaptically, where they mediate tonic inhibition of neurons by ambient GABA. The functional role of tonic GABA current is still obscure (40), but the current could act to reduce network oscillations (41). Potentiation of extrasynaptic GABA receptors likely contributes to the anticonvulsant activity of ethanol, including its protective activity against alcohol withdrawal seizures. Some studies have shown that alcoholism, or chronic abuse of alcohol, is linked with the development of epilepsy in some people.
Long-term or chronic drinking causes the body to develop a physical tolerance. When alcohol consumption is suddenly reduced, this chemical balance that it’s become so accustomed to maintaining changes, resulting in seizures. Developing a tolerance for alcohol has a direct impact on the central nervous system. For abusers, the cessation of drinking can significantly increase the seizure threshold. There is no definitive cutoff for what amount of alcohol you have to drink to experience withdrawal symptoms that increase the risk of seizures. As a general rule, the longer you have been drinking over time and the more you drink, the higher your risk for developing withdrawal symptoms, which may include seizures.
People with alcohol use disorder should be monitored by a medical professional when withdrawing from alcohol. Moderate to heavy drinkers can also benefit from medical supervision in the acute withdrawal stage. When someone drinks alcohol for a prolonged period of time and then stops, the body reacts to its absence. This is alcohol withdrawal, and it causes uncomfortable physical and emotional symptoms. Long-standing alcohol abuse can increase a person's risk of developing epilepsy.
In line with results from animal studies, there is little evidence that carbamazepine prevents alcohol withdrawal seizures and delirium in humans, although it may be useful to treat alcohol craving (1). Similarly, phenytoin is not effective in protecting against the occurrence of seizures in withdrawing alcoholics (71,72). Valproate is protective against alcohol withdrawal convulsions in mice (73). The intravenous formulation is gaining acceptance in the clinical management of status epilepticus so that it could potentially be used in prophylaxis against alcohol withdrawal seizures. Increasing interest is expressed in the potential of gabapentin as a treatment for alcohol withdrawal (74–78) and of topiramate in alcohol dependence (79). Alcohol withdrawal is a distinctive clinical syndrome with potentially serious consequences (see table) (American Psychiatric Association 1994).