Alcohol withdrawal seizures [Neurosurgery Wiki]

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====== Alcohol withdrawal seizures ======

The withdrawal syndrome may begin hours after the EtOH peak; 

Ethanol withdrawal seizures are classically seen in up to 33% (some say 75%) of habituated drinkers within 7–30 hours of cessation or reduction of ethanol intake. They typically consist of 1–6 tonic-clonic generalized seizures without focality within a 6 hour period.
((Charness ME, Simon RP, Greenberg DA. Ethanol and the Nervous System. N Engl J Med. 1989; 321:442–454))

Seizures usually occur before [[delirium]] develops. They may also occur during intoxication (without withdrawal).

The seizure risk persists for 48 hrs (risk of [[delirium tremens]] (DTs) continues beyond that); thus a single loading dose of PHT is frequently adequate for prophylaxis. However, since most EtOH withdrawal seizures are single, brief, and self-limited, PHT has not been shown to be of benefit in uncomplicated cases and is thus usually not indicated. Chlordiazepoxide (Librium®) or other benzodiazepines administered during detoxification reduces the risk of withdrawal seizures
((Lechtenberg R, Worner TM. Seizure Risk With Recurrent Alcohol Detoxification. Arch Neurol.
1990; 47:535–538)).