Alcohol and Seizures: The Risks and How To Reduce Them

Alcohol is a depressant that can affect the brain in a number of ways. In some people, alcohol can trigger seizures, especially when the effects of alcohol are wearing off or during withdrawal. Seizures may be more likely in people with a seizure disorder, such as epilepsy; however, even those who have never had a seizure can experience one after drinking alcohol.

Alcohol and Your Brain

Alcohol mostly affects your brain, stimulating brain receptors that slow and suppress brain activity. This actually temporarily reduces your risk of seizures but ultimately creates a risk of seizure when the alcohol wears off, and this effect is removed.

Effects of Alcohol on Brain Chemistry

Chronic excessive alcohol use is associated with profound changes in brain chemistry, with two neurotransmitter systems being the most affected: 

• The inhibitory neurotransmitter gamma-Aminobutyric acid (GABA) 
• The receptor for the excitatory neurotransmitter NMDA 

The role of GABA in the brain is to limit excitability; thus, GABA inhibits excessive brain activity. NMDA, on the other hand, interacts with its receptor to excite cells in the brain. Under normal circumstances, these opposing chemicals work together to regulate brain activity appropriately, but alcohol use disorders increase the effects of GABA (excess inhibition of brain activity) and reduce the effects of NMDA (reduced excitation of brain activity). 

Alcohol Withdrawal and Seizures

The net effect of excessive alcohol use is globally reduced brain activity that persists for as long as alcohol use continues. Abruptly stopping alcohol use is associated with alcohol withdrawal seizures.

Types of Seizures From Alcohol

Severe alcohol withdrawal is well-characterized as a risk for seizures. Even in the 1960s, seizures during alcohol withdrawal were known as “rum fits.” The risk for seizures during withdrawal is correlated to the frequency and amount of alcohol consumed. While other mechanisms of alcohol-related seizures are less clear, reduced blood sugar levels and altered levels of ions in the brain are potential causes.

It is important to note that alcohol-related seizures and epileptic seizures are different. Alcohol-induced seizures do not meet the criteria for epilepsy, and, with very few exceptions, alcohol consumption and seizures are not associated with the development of epilepsy.

Seizures From Alcohol Abuse

Chronic alcohol abuse is generally associated with seizure activity only during withdrawal. Evidence that acute alcohol abuse (in the absence of alcohol poisoning and non-epileptics) can cause seizures is scarce.

Seizures From Alcohol Poisoning

Alcohol poisoning is a consequence of extreme binge drinking and can reduce blood sugar levels and alter concentrations of ions like magnesium and calcium in the brain. These changes may be enough to cause seizures, but the precise relationship is an active research area. Alcohol poisoning can also lead to decreased oxygen delivery to the brain, increasing the risk of seizures.

Seizures From Alcohol Withdrawal

For someone with alcohol use disorder, the risk of alcohol-related seizures is reduced while alcohol levels are high, but the risk increases as alcohol is metabolized and withdrawal sets in. Abrupt cessation of alcohol removes the “brake” that has been limiting excitability as the brain tries to re-establish normal chemical levels by reducing GABA (increasing excitability) and increasing NMDA receptor activity (also increasing excitability). This process can lead to a phenomenon called “rebound, ” where the brain enters a hyperexcitable state as seizure suppression is removed  and subsequent seizure activity occurs.

Risk Factors for Alcohol-Induced Seizures

While alcohol can increase your risk of seizures, everyone’s risk profile differs. Some people may be more susceptible to seizures, while others will be less likely to experience one. 

History of Seizures or Epilepsy

Someone with a history of seizures or a seizure disorder like epilepsy may be more likely to have an alcohol-related seizure than others. This is partly because they are more sensitive to things that can cause seizures. Alcohol can also interfere with medications used to control seizures, further increasing the risk of seizures. 

Use of Other Substances

Combining alcohol with other substances can increase the risk of seizures. This can include not only recreational drugs but some medications. Alcohol mixed with stimulants, for example, could increase the likelihood of a seizure occurring when the alcohol wears off. Alcohol mixed with a depressant can increase the risk of an overdose, which can lead to decreased oxygen levels that can cause seizures.

Brain Abnormalities or Injuries

Someone using alcohol will have impaired judgment and poorer coordination at the same time. This often leads someone to take part in more risky behaviors while not being able to function like they normally would. Head injuries are relatively common while intoxicated. These can lead to brain injury or damage that can greatly increase the short-term and long-term risk of experiencing seizures.

Heavy Alcohol Intake or Binge Drinking

Someone who drinks alcohol heavily or binge drinks has a higher risk of seizures. Although this behavior actually rapidly suppresses someone’s likelihood of having a seizure, as the alcohol wears off, the likelihood of a seizure rebounds, rapidly increasing and surpassing a normal level of risk.

Prevention of Alcohol-Induced Seizure Problems

The best way to prevent alcohol-induced seizures is by preventing alcohol abuse. Anything more than moderate alcohol consumption (a maximum of one daily drink for women and two for men) meets the criteria for alcohol use disorder and increases the risk of alcohol-related problems, including seizures.

Alcohol-induced seizures nearly always occur during withdrawal. For someone with a serious alcohol use disorder, withdrawal should only be attempted under the supervision of medical professionals who can intervene if complications arise. Often people going through withdrawal will be given a benzodiazepine to minimize the severity of symptoms and reduce the risk of brain hyperexcitability and subsequent seizure activity.

Treatment for Alcohol-Related Seizures

Alcohol use disorders are challenging to overcome, but with help, you can do it! Many people have successfully beaten alcohol addiction and gone on to live healthy lives free from the negative effects that alcohol use can create. 

Alcohol Detox and Withdrawal Management

Alcohol-related seizures are most likely to occur during withdrawal. This is one of the key reasons medical detox is recommended for those who have been using alcohol heavily or frequently. There are many medications that healthcare providers can give during withdrawal management during medical detox. These medications can reduce the risk of seizures occurring and treat active seizures that do happen.

If you or someone you know is struggling with alcohol use, The Recovery Village Ridgefield can help. We offer comprehensive addiction treatment programs that can address all aspects of substance use and recovery.