Seizures associated with alcohol intake

In this post I thought I shall discuss the effects of alcohol on the brain especially with respect to seizures. Many people drink socially , a drink or two after work is not only relaxing but also enjoyable. But who is an alcoholic or rather when does one have a drinking problem? We doctors use the CAGE criteria as a rather simple questionaire to determine if someone has a drinking problem.

“CAGE” where each letter has a question attached to it and the person has to answer yes or no. Let me elaborate a little.

C–stands for “cutting down”–have you ever felt the need to cut down on your drinking?

A–stands for “anger”—have you ever felt angry if someone has questioned your drinking habit?

G–stands for “guilt”—have you ever felt guilty about your drinking?

E– stands for “eyeopener”–have you ever taken a drink first thing in the morning?

If the person answers yes to these questions, he or she may have a drinking problem. What though is the effect of heavy alcohol drinking on the brain? Does it actually kill brain cells (neurons)? Does it lead to dementia? Can too many drinks cause a seizure?

Alcohol contrary to popular beliefs is a CNS depressant and not a stimulant. Alcohol is rather rapidly absorbed through the lining of the stomach and enters the blood stream from where it is carried to the brain. In the brain, it acts on the neurons and initially causes a loss of inhibition. You loosen up, your speech flows more smoothly and soon you become the life of the party. Well as you continue to drink, alcohol then starts depressing the central nervous system (CNS) . People usually fall asleep soon after consuming alcohol.

But let us get back to how chronic alcohol intake affects the CNS especially with respect to seizures.

I shall discuss this one by one.

Alcohol induced seizures

 

 Heavy alcohol consumption can induce seizures. Alcohol induced seizures are of different types. One is what is commonly referred to as “rum fits”. Let me explain with an example. You are out with your friends celebrating a promotion. Your drink for the night is beer. Your normal “limit” is say 4 beers. But hey you are celebrating and so you end up binging. Before you know it you are on your 10th beer of the night. Right as you are having your 11th beer, your eyes roll up and you have a big generalized tonic-clonic convulsion (see my posts on epilepsy on my website http://braindiseases.info) . This kind of seizure which occurs at the height of binging is what has been referred to as a “rum” fit. I guess it was first described with respect to rum. Any of us can have a rum fit if we drink too much alcohol. You do not need to be an epileptic to have a rum fit, though I feel these kinds of seizures associated with alcohol binging are more common in patients who have an underlying seizure tendency. Thus if you are an epileptic you are more likely to have a rum fit if you overindulge in alcohol as regards to someone who does not have a seizure tendency. Hence I always advise my seizure patients to drink alcohol in moderation. You can drink and by all means enjoy your occasional drink but do not overindulge in this pleasure. Know when to say no and walk out of the bar.

Another type of seizure associated with alcohol is what is called “Alcohol Withdrawal Seizure”. Here the seizure occurs in a different scenario. Usually the person is one who is a chronic alcohol drinker, one who is dependent on alcohol and feels uneasy and restless if he does not drink everyday. Let us now assume he suddenly stops drinking for whatever reason. Maybe he runs out of money and cannot buy alcohol. Usually 24 to 48 hours after his last drink, this patient may have a generalized tonic clonic convulsion. As this seizure occurs in the setting of a withdrawal from alcohol, it is called alcohol withdrawal seizure. It is important that heavy and chronic alcohol drinkers keep this is mind and do not suddenly stop drinking. If a person does decide to quit alcohol he should do it under medical supervision.

Now for the third setting in which seizures might occur with alcohol. Again we have a person who is an alcoholic (heavy and chronic alcohol user). Again for some reason he suddenly stops drinking. Uusally after 72 hours, he starts becoming delirious (confused), he has autonomic dysfunction and is tachycardic, sweating profusely, his blood pressure is up. Such a patient is said to be in what we refer to as “delirium tremens” (DT) . Patient who are in DT may have a flurry of seizures one after the other. DT is a life threatening condition and a patient may die if not treated in time. Usually patients are admitted to the intensive care unit of the hospital. We hydrate them aggressively, we give them medications to calm them down. Lorazepam (Ativan) or other benzodiazepines like chordiazepoxide (Librium) are given to prevent seizures and treat acute alcohol withdrawal.

Patients who have had a rum fit, an alcohol withdrawal seizure or even DT do not warrant long term treatment with an antiepileptic drug. These patients do not have epilepsy. If they abstain from drinking in the future it is more than likely that they may never have a seizure again in their lifetime. However there are a few patients whom we feel have a high risk for seizure recurrence, in such patients we may prescribe antiepileptic drug therapy for some time (the duration of the therapy varies depending upon the history, examination findings and the results of investigations like EEG and CT scan or MRI brain)

I have tried to give an overview of the kinds of seizures associated with alcohol intake. Like I stated earlier one need not be an epileptic to have seizures associated with alcohol intake. I try to explain this to my patients as follows. The brain has a threshold for the amount of alcohol it can tolerate. This threshold varies from person to person. If you drink above that threshold, the brain does not like it and one way it reacts is by having a seizure. This “threshold” is lower in patients who have an underlying seizure tendency. In these epileptic patients, a small amount of alcohol may induce a seizure. Also if you mix your drinks or combine alcohol consumption with other recreational drugs like cocaine you are creating the ideal grounds to have a seizure. Certain medicines like antibiotics also lower your seizure threshold and hence should not be used along with alcohol.

Patients with epilepsy should discuss about alcohol consumption with their doctors because at times we doctors do not initiate this discussion of our own. If you have seizures my advise to you would be to drink in moderation and not exceed your limits.

Nitin Sethi, MD

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200 thoughts on “Seizures associated with alcohol intake

  1. My son has had 6 grand mal seizures in the past 3 years. He is now 25. After 2 seizures his license was removed and each time he almost went 1 year seizure free to reinstate his license he had another seizure. In the past 2 years he was almost alcohol free, but he drank after 1 year alcohol free and had a seizure which put him back on the waiting list. Now he has gone another full year without a seizure and no alcohol. Last night he drank 0% beer at a party and suffered a mild (30 second) seizure.
    Is there something in beer that he may react to ? Do you have a direction to go with this?

    • Dear Peter,
      thank you for writing in. It is likely that your son has an underlying seizure tendency (propensity to have seizures) and alcohol brings it out. There are a couple of things which I would advise you. One would be to have your son see a neurologist/ epileptologist. The doctor shall review his history and physical examination and then may order a few tests namely an EEG (brain-wave study) and a CT or MRI scan of the brain. The EEG shall help in characterizing what kind of seizure disorder your son has and shall also be of value in prognostication purposes. The CT or MRI scan shall aid in ruling out any underlying structural lesion in the brain.
      Depending upon the results of the above tests, your son may warrant to be on some anti-seizure medication. Also since alcohol obviously brings out the seizures in his case, he should complete abstain from it. The rules with respect to driving vary from state to state. In New York state you have to be seizure free for 1 year (on medication) before you can drive. You can read more about the same on my website http://braindiseases.info.

      Personal Regards,
      Nitin Sethi, MD

      • I was diagnosed with epilepsy 12 yrs ago been on everything from epilim to lamictal to tegretol now keppra I now think my drinkin has a big part to play with my seizures I answered yes to all 4 questions if I stop drinkin will my epilepsy leave me alone I hav about 4 fits a mth

  2. Thanks for the reply. I am from Canada and am familiar with the driving restrictions here. I wanted to bring up in the history that my son had a minor seizure recently and NO alcohol was involved. The seizure was about one half of a minute and he experienced it after a late night with very little sleep. Does this fit your profile that he has a tendency toward seizures, but may have different triggers? It was suggested by one doctor that sllep depravation might cause a seizure also…what else would be considered a possible trigger?

    Thank you so much

    P

    • Thank you for writing back Peter. Patients who have an underlying seizure tendency, frequently have a seizure if they do not sleep well the night before. In fact sleep deprivation is frequently used to trigger a seizure when we monitor these patients in an inpatient video-EEG unit (epilepsy monitoring unit). We basically ask these patients to try to remain up the whole night. Lo and behold the next day, many of them have a seizure which we can then record on the EEG machine to help us characterize it.
      There are many seizure triggers or rather events which lower the seizure theshold. Lack of sleep, alcohol, certain drugs (antibiotics like ciprofloxacin, certain anti-depressants), recreational drugs like cocaine all have been implicated in lowering the seizure threshold.

      Personal Regards,
      Nitin Sethi, MD

      • The question is what is the process by which sleep deprivation drugs and alcohol cause seizures. The answer is How does the Ketogenic diet work?
        I believe I may have an answer for that question, and have written a case study regarding my sons seizures and the Ketogenic diet. If there is interest I’d be happy to discuss.

      • He’s doing great thank you. Son’s Neurologist would not prescribe the ketogenic diet unless he failed two drugs, so we put my him on a Low Glycemic Index diet which is almost as effective, plus supplements, Mag, Vit E and B vitamins. Seizure free for over 4 years.
        Diet better than drug side effects, IMHO.

    • Hi Peter, I thought I would reply after reading your post and after being diagnosed myself epileptic 3 years ago. There are many different factors that can cause a seizure; brain injuries, tumors, cysts, stress and/or depression..etc. My advice to you is to alway get asecond,third,fourth opinion and never let your Son settle for the first medication they offer him. I realize I am replying 2 years later but I hope this helps.

  3. hi, i suffered my 2nd seizure in october last year. my first 1 was 6 years ago. i usually go out most w ends and suffered my seizure 4 days after the last night i was out. i was not sleeping very well that week and felt very confused the day before it happened.

    am i likely to suffer more attacks if i carry on going out at w ends? i have read its alcoholics that get these attacks and i dont consider myself to be an alcoholic as i only go out at w ends when im not working. it has never happened to any of my friends and its all a bit hard to take in. i have had an mri scan and have my eeg on the 23rd. just looking for some help and advice if pos.
    thanks.

  4. Dear Colin,
    thank you for writing in. It is possible you have an underlying seizure tendency which is brought out by your weekend drinking and late nights.
    My advise would be to bring it to the attention of your doctor. He/she may want to refer you to see a neurologist.

    Personal Regards,
    Nitin Sethi, MD

  5. My roomate came back last night at about 1am. I could tell she was drunk, but not anymore than usual when we go out. She was a little incoherent however, asking if she could urinate in our trash can. Throughout the night she was snoring like a bear, and I kept getting up to nudge her and put a pillow under her head, which usually works. Most times, she will wake up when I do this, but she did not. She had an 8:30 am class this morning and my friend came back frantically at 9am saying that my roomate had collapsed in class and had what she thought was a seizure. She is now at the hospital. I’m so shaken up! Most of the posts that are up have to do with people with alcoholism and seizures. My roomate is definately not an alcoholic, but she does binge on occasion. With no record of any previous seizures, I wonder what could have caused this? Thank you for your time

    • Dear Sarah,
      thank you for writing in. Your room mate is indeed lucky to have a friend like you. While I cannot comment on her case in particular, my advise would be that she needs a basic work-up to determine the etiology of her episode (collapse, loss of consciousness and seizure like activity).
      It is indeed likely that she may have had a seizure precipitated by excessive alcohol intake the night before. The money though lies in determining how likely she is to have a similar episode again in the near future and whether she needs to be on any medications.

      Personal Regards,
      Nitin Sethi, MD

      • I know this post is old but thought I would try.

        My husband has had very similar ‘episodes’ as the girl’s room mate. On more than 1/2 a dozen occaisions, my husband has binge drank (hard liquor or WAY too much wine) and the next day, generally after eating (so the thought is there is some association with blood sugar even though my husband has a perfect bill of health) he has had a seizure then been ‘dazed and confused’ for a few hours. He has received hospital care (one time it happened at the hospital where I was in the ER for a separate injury, another time while hiking, and other times either just walking down the street or laying on the couch – so 3 times in total he was tested by a paramedic) Thankfully i BASHED into his head that he needs to not drink like that – binge drink and he’s been seizure free for about 2 years…. likely because the last seizure happend 20 minutes after he was holding our 6 week old daughter! So like the writer of this post, I feel like there is some type of middle seizure area where they can be induced by long term or excessive binge drinking.

      • Dear Johanne,
        it is indeed good that your husband is now abstaining from alcohol completely. The thing which always worries me about seizures is not the seizure itself. The seizure usually stops by itself in a minute or two. But it is the circumstances surrounding the seizure which can prove to be very dangerous. Seizures are associated with fall and hence there is always the potential for seizure injury. If you have a seizure while driving, you are extremely likely to have an accident and injure yourself and others on the road. In New York City if you happen to have a seizure while standing on the subway platform waiting for the train, you may fall into the tracks and the end result may be fatal. I always tell my patients ‘you do not want to have a seizure at the wrong place and at the wrrong time”.
        So make sure your husband does not drink and you should bring these episodes to the attention of his primary care physician so that a thorough work up can be done.

        Personal Regards,
        Nitin Sethi, MD

  6. I am wondering about if you could summerize some info on this disease i am tring to find tid bits of info for a report at school. Is drinking the only drug that causes seizure withdrawl syptoms and why is epilepsy so different from seizures induced by alcohol.

    • Dear Jessica,
      thank you for writing in. There are many factors which can provoke a seizure, some internal and some external. Let me explain further. Patients who have a seizure disorder frequently experience seizures if they do not sleep well at night (in simple words, lack of sleep stresses out the brain), if they fail to take their seizure medication or more commonly miss a dose then too they can have seizures.
      There are many drugs which lower the seizure threshold. Alcohol is a central nervous system depressant and too much alcohol intake (binge drinking) can provoke a seizure. This usually occurs in people who have an underlying seizure tendency ( meaning they have a seizure disorder and alcohol brings it out). That said and done anyone can have a seizure if he or she drinks way in excess (see my post on “rum” fits on my website http://braindiseases.info).
      Other drugs of abuse such as cocaine and estacy also may provoke a seizure (especially when people mix drugs and take it with alcohol). Further there are some antibiotics and anti-depressants which may on occasion cause a seizure (in some people).
      Epilepsy refers to a condition which is characterized by recurrent seizures (also referred to as a seizure disorder). On the other hand seizures induced by alcohol may not be recurrent (provided the person abstains from further alcohol intake).

      Personal Regards,
      Nitin Sethi, MD

  7. My son is 21 and we determined about 18 months ago that he is an alcoholic.He is determined that he can quit on his own, he can’t. He refuses to get help. About 5 months ago we did convince him to go to a hospital for detox. Two days after being released he drank and fell down a full flight of steps and lay unconsious on the floor.
    Since then he will drink for a few weeks then he will try to quit again, he will usually make it sober for about 2-7 days before he relapses. His age doesn’t help he is determined he can teach himself to be a social drinker like his friends. We keep telling him that will never happen he has to quit for good. Anyway he has expierenced every withdrwal symtom there is except hallucination [At least that I know of]. Yesterday he came to our house and was on the computor I heard strange noises. When I went into the room he fell off the chair. His body was flinching all over his eyes were really wierd, there was slobber coming out of his mouth, and he was totally
    unaware of what was going on. He was all clammy with sweat and very pale. It lasted about 5-10 minutes before he even reconized me. [He said he had not drank in 3 days and appeared to be sober]. He does not remember anything except lifting his arm while sitting in the chair and then me waking him up[his eyes never closed,just were really weird looking like he wasn't in there]. He later told us that a few months ago he was working at his place and he woke up on the floor with his tool belt on and he did not know what happened. I am assuming that this was a DT seizure. Should we expect this to happen more often. And is there any warning. How bad of shape is he in? At the hospital they told us he was malnutricianed, dehydrated and had high blood pressure. We are also very concerned about his stomach and his throat. Any advice you can offer would be greatly appreciated. We are trying to convince him to get some help. Could the fall be any part of this?
    Thankyou
    Vicki

    • Dear Vicki,
      I am sorry to hear that your family is passing through these difficult times. It is possible that your son is having alcohol withdrawal seizures (likely precipitated by his frequent unsuccessful attempts to give up alcohol). Sudden cessation of alcohol intake by a chronic alcoholic can precipitate alcohol withdrawal seizures and at times delirium tremens. I want to add that at times DTs can prove to be fatal and hence should not be taken likely. We think of them as medical emergencies and patients are frequently admitted to intensive care unit for close observation and monitoring. The fact that your son is malnourished and dehydrated also worries me.
      I would make sure he gets good care and follow with his doctor on a regular basis.

      Personal Regards,
      Nitin Sethi, MD

  8. Hello
    My 48yr. old brother is an alcoholic and uses pot regularly currently. About 15 years ago he had seizures at work and wound up in the hospital and had had 2 more there. He was placed on anti seizure meds and quit drinking and doing drugs for several months. He was told the seizures were a result of the mix of drugs/alcohol he was doing. He has since stopped the meds (on the anti seizures meds for only a few months) and has been seizure free since then til last October. He had resumed the drinking and avoids the heavier drugs since the first seizures 15 years ago. He tried rehab 4 years ago for 2 months but that didn’t help and he had NO seizures at that time. In October while at work, he had another seizure. He had done no heavy drinking and had his usual beer that morning prior to working and seizuring. He had been without a drink for about 6 hours. The doctors have no idea what is wrong and tried to say it was a with drawl seizure but we think not. Currently we are awaiting the results of an MRI and found out he has an enlarged heart. He has started out patient counseling and given up alcohol (with no seizures so far). Is it still possible to have a seizure that is alcohol related in this case? Thanks

  9. Dear Mary,
    it is more than likely that alcohol is still playing a role in your brother’s intermittent seizures. Whether we label the seizure as alcohol withdrawal or something else, I feel is just playing with words.
    It would be best that he abstains from alcohol completely. Whether he needs to be on long term anti-seizure medication shall be best decided by his doctor after reviewing his history and results of tests such as EEG and MRI.

    Personal Regards,
    Nitin Sethi, MD

  10. Hi,

    I have been drinking pretty regular for the last seven years. In the last few months I am noticing I have very bad anxiety the day after drinking. I am afraid I am going to have a seizure. I don’t drink every day but several times a week for sure. I have cut that down to twice a week, but I still have the bad panick the next day. My fear comes because my head feels weird the next day, my throat, tounge and sinus feel like they want to gag me on an off, an then I get spooked that that it is a seizure coming on and then I have a panick attack. I have never had a seizure though. Just trying to eliminate the fear and hoping you can help. When I drink its like 5 to 7 beers over the the course of 9PM to 2AM with maybe 1 or 2 shots in there. On a night like that I am pretty tipsy and the next day will feel like dog poo. Anywho by 1:30pm or later that next day is when my head starts feeling funky and brings on the panic of a seizure. Do you think I am a candidate of having a seizure? I hope not. My goal is to stop drinking all together. Just fighting through the social changes in implements. Thank you for your time and feedback.

    Chris

    • Dear Chris,
      Thank you for writing in. Anyone who drinks heavily is a candidate for a seizure, some more than others. If it makes you feel so sick the next day, it shall be a wise decision indeed to abstain. It is tough like you said but can be done and I would only encourage you in that endeavor.

      Personal Regards,
      Nitin Sethi, MD

  11. Our 18 year old son most recently has been traveling in Southeast Asia with a few of his friends. By their own admission, they have been consuming large quantities of beer, rum and marijuana on an almost, if not daily, basis. Added to this by our son, was a half tab of ecstacy and a small quantity of opium (smoked). After a two month period, they were rafting down a river in Laos where at very frequent intervals they stopped at the river side bars and drank buckets of hard liquor. After the forth day of this, my son started to complain that he was feeling unwell. He decided not to participate one particular day, opting to stay at home in their bungalow. He started having a migraine like headache around dinner, that was followed by intense feelings of nausea resulting in copious amounts of vomitting by about midnight. At around 4:00am in the morning, his friends witnessed our son going through what was later diagnosed as a grand mal seizure. They managed to get him to the hospital that was five minutes away, where infront of a non English speaking Laotian doctor he suffered his second grand mal seizure. He remembers nothing of the first event, but remembers feeling what he described as an electrical storm raging between his head and the end of his spinal cord. The doctor gave him a shot of Diazepam and without any further testing sent him out of the hospital. On the medical notes, the doctor diagnosed him with Epilepsy. During the first event, he foamed at the mouth, his eyes rolled back and stayed fixed, his body shook with violent tremors and he was arching his back. He returned to his bungalow and slept for the rest of the day at which point we were contacted. I flew to Laos immediately and met him two days after the seizures. He looked dull and dopey. I was afraid to take him home immediately because of the long flights involved and instead chose to take him to quiet bungalow on the beach near a larger hospital in case of emergency. For two weeks I re-hydrated him with clean water, he ate good food and got plenty of rest. In that time I noticed a real improvement in the clearing of his eyes and in his general health overall. There wasn’t any alcohol and marijuana to be had so it was a cold turkey approach to those substances. He did not have any other episodes and only complained of very minor headaches for the first three days. We have returned home and his father and I have tried to explain to him about the dangers of returning to using the substances that he was. He feels that the episodes were “a one of” kind of thing and we are trying to educate him about the possibility that there might be some really good reasons for the seizures that he had. He seems to fit either profile; alcohol induced or alcohol withdrawl. We have heavily suggested that he resist any drinking or smoking of marijuana (or any other drugs for that matter) until he has undergone extensive testing to help determine what the root causes might be for these episodes. He is not responding in a positive way….and until I found your website, I didn’t know where else to research any of this. I would truly appreciate any insights you may have with regards to what all of this could mean. I will show him your response as one of many that we will solicit so that he can see the wisdom in the replies. You have a very straightforward way of responding and I believe he will come to see the rationality of abstaining from substance abuse once he receives an ‘outsiders’ opinion. Many thanks for any assistance you can give us.

    • Dear Trudessa,
      thank you for writing in. I always feel parents love their children so much and would do anything for them. Your love and concern for your son’s health is apparent. I am what I am because of my parents love and I thank them for that.
      Well I shall not mince words. Mixing alcohol with recreational drugs and especially binging is like playing with fire. Seizures are common when drugs and alcohol mix and at times can prove to be fatal. One can suffer a cardio-respiratory arrest (you stop breathing or your heart may stop). I see many people brought to the ER in this state after a night of partying which involved heavy alcohol use and drugs. Some suffer brain insult and are left in a vegetative state.
      I paint the worse possible scenario, not to scare anyone just laying the facts on the table. My advise to your son would be to abstain from alcohol and drugs completely. Life is beautiful and he has too much to lose if he continues to drink and do drugs.
      I wish him and you my very best.
      Personal Regards,
      Nitin Sethi, MD

    • Because your son traveled, I would be aware of any parasitic infestations that can lead to seizures. There is a pretty good list of them on humaworm.com.. I am not promoting the product, although it DOES work, I am merely pointing out that some developing countries have more worms/parasites than US and could potentially be causing ALL of his problems.. Here are some examples:

      SCHISTOSOMIASIS – this infection comes from contaminated fresh water. Days after infection, itchy skin or a rash develops – after 1-2 months, fever, chills, cough and muscle aches set in. The body reacts to the eggs produced by these worms, not the worms themselves. The eggs can be found in the brain, spinal cord and can cause seizures, spinal cord inflammation and paralysis. The parasite can damage the liver, intestines, lungs and bladder.

      BLOOD FLUKES – travel all over the human body and into all organs including the brain and spinal cord. They can cause seizures and they destroy red blood cells.

      • Dear Sarah,
        thank you for writing in. Parasitic infestations of the brain are a frequent cause of seizures in young adults specially in the developing countries. With international travel becoming more and more common, we are now seeing many such patients here in the United States too.

        Personal Regards,
        Nitin Sethi, MD

  12. Many thanks for your response Doctor….I do have one question though? In his everyday life here in our community the substance abuse (drinking and smoking pot) is not a daily event. Mostly it occurs during the weekend. During his trip abroad, he was also taking Doxicillin (? Antibiotic taken to ward off the effects of Malaria) at a rate of one pill a day. Could the antibiotic, along with the already mentioned alcohol and recreational drugs, have caused these two seizures? Is it at all likely that he may never again suffer a seizure if he was to continue in the mode that he does while at home? We totally agree with you that abstinence would be the most desired approach….but at 18 he seems to think he knows his body and himself better than any of us. My husband and I do not drink or do any kind of drug whatsoever…nor have we ever in all the years we have been raising our three children (24). The downside is this; in our community, it is a most accepted way to pass your recreational time with adults and children partying together. We often feel that it is time to move…but also realize that might not be the solution to this problem. Again….many thanks for any attention you can give these last questions of mine. And thank you for providing this forum…..it is a wonderful way to be of service to humanity.

  13. Dear Trudessa,
    you are very welcome. Some medicines and that includes antibiotics like ciprofloxacin (and other members of the quinolones group) may lower seizure threshold and precipitate a seizure in people who have an underlying predisposition to have a seizure.
    It is possible that your son has an underlying seizure tendency and the mix of drinks, drugs and maybe antibiotics precipitated the convulsion.
    It shall be indeed wise to abstain completely from alcohol as well as recreational drugs. The question whether he may have another seizure in the future can be best answered by his doctor after going over the results of some basic tests like an EEG (electroencephalogram–a test which looks at the brain waves).

    Personal Regards,
    Nitin Sethi, MD

  14. Hi,
    My Mom is about 55 and has been a pretty heavy drinker for the past 20 or more years, she drinks about two glasses of wine a day, binge drinking about once or twice a week, and her drinking was much heavier ten years ago. I don’t really know if she is an alcoholic but her drinking is defintely excessive, she has difficulty quiting and can only last about a month before drinking again, and is constantly ill with infections and many other things such as breast cancer, hernias, rheumatoid arthritis, IBS, high blood pressure, etc. About a year and a half ago, she had a seizure in the middle of the day, her first seizure ever. She says the doctors called it a “Grand Mal” seizure and diagnosed her with epilepsy and she has been taking Topomax ever since, I believe. I do not think she was drunk when the seizure happened, though I am not sure. I was wondering if her history of drinking could have caused the seizure and if her continued drinking puts her at a high risk for another seizure. Thanks so much.

    • Dear Pamela,
      thank you for writing in. Yes both heavy alcohol consumption and sudden cessation (by a person who is an alcoholic and drinks heavily on a regular basis) can provoke a seizure. Alcohol lowers the seizure threshold especially in persons who have an underlying seizure disorder. So yes, your mother’s heavy drinking does put her at risk for another seizure. Have her see a neurologist, he or she shall be able to determine if your mother has an underlying seizure disorder or whether all her seizures are related to alcohol abuse.

      Personal Regards,
      Nitin Sethi, MD

  15. Dear Dr. Sethi,
    Thank you so much for replying. My mother did see a neurologist immediately following her seizure where she was supposedly diagnosed with Epilepsy, which you did say is an underlying seizure disorder, I believe. But what I was wondering is, even with Epilepsy, could the seizure have been brought on by alcohol? I don’t think she was on an intense binge of drinking and suddenly stopped, she just usually drinks like 2-4 glasses of wine a day and occasionally binges for a night like once a week. Also, she is on Topomax, an anti-seizure medication, and shouldn’t she be completely abstaining from all alcohol on that drug? Thank you so much for helping, I really appreciate your answers.

    • Dear Pamela,
      alcohol likely is bringing her seizures out. My advise to her would be to abstain from alcohol completely.

      Personal Regards,
      Nitin Sethi, MD

  16. Hi,
    i have had alcohol induced seizures i believe five to be exact. i do not consider myself an alcoholic as i only have a few beers with my friends on the weekends. i do not drink everyday, or even every weekend. i go good for about a year and then it seems like i just over do it one night, but when i drink in moderation nothing happens and in my case i always have the seizure the next morning after a night of drinking more than i should. i have seen doctors and had mri’s and eeg’s and they said i am not epileptic. i am trying to quit and have been doing really good although i dont want to quit because i am 22 years old and i enjoy drinking socially with friends and family. i was wondering if there is any cure or medicine to take just in case u have too many one night.

    • Dear Nick,
      thank you for writing in. Unfortunately no medicine to take the “night after”. My advise to you would to be to drink in moderation. If you drinking to the extent that you have a seizure, then you are drinking way too much. It may be fun at that time but you are playing with your life.

      Personal Regards,
      Nitin Sethi, MD

  17. My wife is 59 and recently had what the ER doctor described as an alcoholic siezure. Yes, she drinks wine excessively everyday and has done so for at least ten years. She does not have a history of epilepsy. She is reluctant to see a doctor and chooses to abstain with great success for the last full week.
    The siezure made her eyes roll back, she was foaming at the mouth and starting to get gray in skin color. We thought she was choking so we performed the Heimlech manuver which seemingly brought her back to consciousness.
    Having read the above articles, I tend to think she is not an acoholic, but I would appreciate your comments especially about the seizure description. I need to mention, that my wife did aerobics, yard work and tennis all day and did not eat much. I have seen her consume more wine than she did that evening so do you think that this was probably an isolated incident or aside from drinking too much wine a serious condition that I can more firmly argue for a doctor visit?

    • Dear James,
      thank you for writing in. Your description of your wife’s seizure sounds typical for what we as doctors refer to a generalized tonic clonic convulsion-the patient stiffens up, the eyes roll back followed by convulsive movements involving the arms and legs. The patient may bite his/her tongue and have loss of bladder control (wetting their pants in the process). Usually once the convulsion is over the patient is confused and disoriented for a short while (we refer to this state as the post convulsive or post-ictal state).
      It is difficult for me to predict whether your wife indeed had a seizure (and if that was the case whether it indeed was due to over indulgence in alcohol) or whether she had some other paraoxysmal event which may resemble a seizure superficially such as a syncopal episode or a syncopal convulsion. My advise to you would be to coax her to see a doctor. A relatively simple work-up shall help clarify the diagnosis. Till then abstaining from alcohol seems like a wise thing to do.
      Personal Regards,
      Nitin Sethi, MD

  18. My boyfriend suffered his first ever seizure this weekend, around mid day. The signs all look like a general seizure, pre-indicator to the event, severe shaking,loss of conciousness,eyes rolling, red/blue face lateral bite to the tongue etc.It lasted several minutes followed by a period of heavy breathing and unawareness.

    This seizure came on following a very long day at a corporate event, where he consumed a very large amount of alcohol (from lunchtime to 10pm)and was taking high strength paracetamol-asprin (6 consumed over the period of the day every 4 hours-).
    Ridculously, he then went on a bike ride the following morning (9am) in a sweat suit to try and sweat out some of the toxins.Following this he appeared ok, but had not drunk much fluid or eaten.
    He is going to have an EEG and scan, but do you think the excessive behaviors are likely to have caused this and can they eliminate any underlying condition?

    • Dear Michelle,
      from your history it seems likely that your boyfriend had a convulsion which was provoked by the combination of consuming too much alcohol, use of over the counter pain medications and dehydration. The EEG shall help to identify whether he has an underlying predisposition to seizures and the CT scan shall help to rule out any underlying brain lesion.
      Depending upon the results of these tests, his doctors shall determine whether this was a one time event or whether he has epilepsy making him prone to having seizures in the future. The work up shall also determine whether he needs to be on anti-seizure medications.

      Personal Regards,
      Nitin Sethi, MD

  19. Dear Dr. Sethi,

    I am up late at night as I am having an EEG at 7:30am and am not supposed to sleep…For about 20 years I’ve been a fairly heavy drinker. When I was younger I seemed to binge more when I was in college and so forth. These days I drink about a 1/2 bottle or 2-3 (sometimes 4 – mostly 3..) glasses of red wine 4 nights a week or so. I don’t drink during the day and have never been spoken to about my drinking or have ever been in any kind of trouble for it. However, I assume it is not healthy. But I have a tremendous amount of anxiety (Generalized Anxiety Disorder), have battled Chronic Fatigue Syndrome and Fibromylgia for years and just have terrible sleep problems. So the alcohol helps with my anxiety and helps me sleep. But about a year and a half ago I started having what my neurologist wonders might be seizures. I have had a CT brain scan, did a sleep study, blood tests and the EEG will be the last test. They only happen precisely when I am transitioning to sleep on the nights I don’t drink. Sometimes I have mild ones on the nights I do drink – but mostly these happen only on nights I do not. I don’t loose consiousness (sp?), my eyes don’t roll back. But I have involuntary movements – sometimes it’s a finger, leg, my whole torso, a foot – very random. I also experience a sensation of dizziness – or a feeling of going down a roller coaster – it is very unsettling. I sometimes lose my breath, sometimes I have vocalizations. I might not have mentioned, I also take 2 benedryl every night and have for 7 years. My sleeping problems are so bad – that sometimes I’ve taken 3 benedryl and drank wine and cannot sleep. I eat well, take vitamins and run 4-5 miles every other day. But I also am a perfectionist, suffer from some depression as well as the anxiety – so this is why I’ve been drawn to wine. I keep in in check – with regard to taking a few nights off, and not continuing to increase the wine I drink – but something is telling me it could be the cause of these movements – unless it is anxiety related. Will the EEG be the test that determines if these are some kind of seizure related to alcohol? I am seeing a neurologist that seems pretty competent – but I would love any guidance you could provide.

    Most Sincerely, J

    • Dear Jennifer,
      you likely had a sleep deprived EEG. I doubt these jerks/ involuntary movements at night represent seizures. One of the ways to characterize them though is to have a video-EEG study. Basically you are admitted to the hospital and hooked up to an EEG machine which is time locked to a video-camera. If you have the jerks and there is no EEG correlate (meaning you have the jerks but the brain waves do not change), then likely these are not of cortical origin and hence not epileptic.
      Personal Regards,
      Nitin Sethi, MD

  20. Dear Dr Sethi

    Thank you for the informative post and thread. I have been a fairly steady drinker since my early twenties and am about to turn 40. I rarely go out, or stay in, with the intention of ‘getting drunk’ but I enjoy the taste of wine and bourbon. I also suffer from varying degrees of anxiety and am a Type 1 diabetic and I like how a glass of wine or two with dinner helps both my anxiety and sensitizes the insulin that I take.

    Last year, when my mother died, I was under an incredible amount of stress and was drinking much more heavily in order to “self-medicate” with the anxiety. One morning I awoke from a a dream that I was laying back on a couch with my head tilted back and I felt all the blood rush into my head as if I suspended in the air by my legs. I immediately woke up but when I did, that awful feeling still persisted for at least a minute or so. I was afraid to stand up and had to call to my roommate of the time, to help me. Eventually the dizziness stopped but I was so shaken with this experience, that I had to sit on the couch and do nothing for fear of it happening again and eventually checked myself into ER. They gave me some fluids and a Xanax and then took me for an MRI and found nothing wrong. They attributed it to stress, fatigue, and dehydration.

    I have not had anything like that for a year but this morning I had two almost exact episodes, one after another. I had just returned from a trip out of state for a friend’s wedding where I not only overindulged but also got into a big fight with my wife which probably made my stress hormones skyrocket. It happened this morning, again as I was dreaming about my head being tilted back and at that exact time that I dreamt of blood rushing to my head, I would wake up but feel like everything was moving around and we were having an earthquake. 30-40 secs later it would stop.

    According to what I’ve been reading about this doesn’t sound like an alcohol induced or alcohol withdrawal induced “seizure”. Or is it? My blood glucose when I tested it was a little high but not outrageous (170). Any opinions on what these couple of episodes and symptoms might mean?

    Many thanks

    • Dear John,
      thank you for writing in. I shall not attempt to diagnose you over the internet, that is the privilege of your doctor who has had the chance to take a detailed history and exam you. Your events as you describe them though sound atypical for seizures. It is possible they are “stress induced”. There are many times when patients have neurolgical events which remain undiagnosed. You should though bring it to the attention of your doctor. He shall be the best man to decide if any further diagnostic work-up is warranted.

      Personal Regards,
      Nitin Sethi, MD

  21. Dr. Sethi,
    How far gone is ones internal organs when they start to have internal bleeding and the liver and kidneys stop functioning correctly?
    This gal I’m questioning about has been a heavy drinker since she was about 18, and she’s now 37. She was just admitted to the hospital last week for this situation, and is now home. I don’t know all the details, but I’m concerned because she isn’t getting help for her alcohlism, and she has a young son at home. We know she’s not going to stop even though she knows this is killing her.

    • Dear Julie,
      thank you for writing in. I think you mean what we refer to as alcoholic liver disease. Alcoholic liver disease passes through 3 stages–stage 1 is the stage of fatty liver (the liver starts accumulating fat but otherwise functions well), stage 2-is the stage of alcoholic hepatitis (the patient starts having jaundice and other signs that the liver is not doing so well), stage 3–is the stage of alcoholic cirrhosis (in this stage the liver starts failing–the patient may present with signs and symptoms of liver failure). He or she might have oral bleeding due to rupture of dilated blood vessels near the junction of the esophagus and stomach. We call these gastroesophageal varices. The liver does not clear ammonia and the high ammonia affects the brain making the patient encephalopathic. We call this hepatic encephalopathy.
      Afraid at this advanced stage the only thing which can help is a liver transplant. Provided the patient is sober and determined to be so. I wish your friend my very best.

      Personal Regards,
      Nitin Sethi, MD

  22. My seizures started in 2003 in NY and I did nt know i had on e with my tongue bite.

    i then noticed that if I took more drinks i will have a seizure free night.

    All my seizures have occurred when i am either falling asleep or trying to wake up.

    what I have established is that that after a night of heavy drinking the following day I must have some beers else trying to sleep will be living hell.

    I have never had a seizure while awake.But after 2 very serious seizure in the last 7 days I have decided to only take 4 beers coz if I dont definetely i will have an attasck

    • Dear James,
      thank you for writing in. Many people have an underlying seizure tendency (propensity) and alcohol “brings the seizure out”. My advise to you would be to gradually stop drinking alcohol altogether.

      Personal Regards,
      Nitin Sethi, MD

  23. This is actually quite a fascinating article to find. I am not certain if it pertains to what I experienced a few weekends ago or not, but I thought that I would post my story to see if I could get any insight from you.

    I don’t drink all that often. A drink or two here and there with a friend, but not even every weekend. A few weeks ago I had gone to visit some friends, and there was drinking to be involved in the night’s plans. I had eaten, although probably not as much as I should have. I had maybe two beers and 2-3 rum and cokes. After this, I turned down any other drinks as I was feeling intoxicated, but still quite aware of what was going on around me. After an hour or two, I accepted a final drink, but only had a little bit of it before I lose almost all memory of the night.

    According to the friends that I was with, I continued the conversation that I was having for a little while longer. All of the sudden, they said that I slumped over onto the person next to me. They tried to get me to stand up so that I could drink some water, and I ended up collapsing. At this point, I started breathing heavily – like a cross between hyperventilating and not being able to breath. I did this while pulling in toward my left side and could not respond to anyone. I did this for about five minutes, and they had everyone clear out of the room and I seemed to come out of it. I was in an altered state of mind and was mixing up the past with the present and had to be told several times who I was talking to before I would calm down. However, I never lost consciousness and was able to talk to people in between these episodes.

    This happened multiple times throughout the night – on and off like this (five minutes of weird breathing/twitching, then five minutes of calm). As the breaks got longer, the episodes would get shorter. Eventually, they got me to go to sleep. Later that night, one of them heard me breathing weird again. They came out to find that I had gotten sick everywhere. I was calm for a bit, and went in and out of these episodes again.

    When they woke me up the next morning, I knew that something had happened that I didn’t fully understand, but I had (and still do not have) almost no memory of the events that occurred. I had an MRI and an EEG done, and both tests came back normal. This is the first episode like this that I have ever had, even though I have gone with only a few drinks here and there for a long time and then drank a bit more excessively on rare occasion. I have never had anything like this happen to me in the past when I have done this, and I have yet to find any answers as to what may have happened.

    • Dear Evan,
      thank you for writing in. Your doctors may never figure out what happened to you that night (and this by the way is quite common). Some neurological episodes of impaired consciousness (note I did not say loss of consciousness) frequently remain undiagnosed and one is not able to rule out or rule in a seizure disorder. MRI brain and EEG come back normal as was in your case.
      At times when our index of suspicion for a seizure is high, we may order a longer duration EEG (we call this a 24 hour ambulatory EEG study).
      Whatever was the etiology of that episode, it shall be wise to drink in moderation from now on.

      Personal Regards,
      Nitin Sethi, MD

  24. To anyone who drinks alcohol and has a seizure, please understand that once these seizures start taking place, EVERY time you drink you will run a risk, however small, of another seizure AND they can get worse over time, eventually killing you. Why is this worth taking a chance on to anyone, even if it’s only a 10% chance or a 15% chance? What if it’s a 98% chance? Is that high enough to make you or your loved one stop? This is your very life we are talking about. Alcohol IS a poison and not all human bodies are equipped to deal with it effectively indefinitely. The liver can break down over time making even the smallest amount of alcohol dangerous even if you’ve drank much more in the past without consequence.

    Someone close to me took four seizures to finally get out of his denial that the alcohol wasn’t causing them, or that he could control the drinking, or that he will somehow escape having a seizure “this time.” I witnessed the forth seizure and know and understand how very violent these are and how close it can come to claiming a life. I have never been more scared in my life. Even if the seizure didn’t kill him, what if he had been driving? What if he fell the other way into the water instead of the way he fell? What if I hadn’t been there?

    I nursed him for 10 days following the seizure. He couldn’t walk without assistance, use the bathroom or shower without help, couldn’t hold a glass to his mouth without assistance, couldn’t sign his name, and couldn’t remember facts properly. Basically, a helpless invalid for at least a week. Sexy? Right? And who is going to take care of you when it happens like that to you? My guy was lucky. He had me.

    The research I did following the seizure explains why the seizures occur. Your brain is trying to maintain a chemical balance. When you drink, you are depressing the brains ability to receive certain signals so your brain compensates; it’s like turning up the volume on a stereo or adding more amplifiers when you have a pillow over your head. Remove the pillow and you’ll get sound blasted. Remove the alcohol and you get brain-chemistry blasted. When the alcohol leaves your body, your brain is in overdrive and doesn’t know how to turn the volume back down or remove the extra amplifiers compensating so your brain chemistry would be “normal” when intoxicated. Now imaging being intoxicated every day what that is doing to your brain. Consider yourself lucky if you are a heavy consumer and don’t have seizures. And if you’ve ever had one, there is EVERY reason to believe you will have another no matter what doctor diagnosed you with what. If there is a reason to believe you might, assume you will and stop drinking. It’s not worth it and it is shockingly dangerous. Drinking alcohol is playing with fire. So please stop searching for the “answer” which makes you different. You’re not. It’s physiology of how the brain works and what alcohol does to every brain. If you drank alcohol and had a seizure during or after, you are at risk.
    And if you are drinking to prevent the seizures, go to the hospital and go through detox. They will most likely give you Lorazapam or other anti-seizure drugs to get you through the withdrawal. Once the alcohol is out of your system and you are clear of seizures you most likely won’t have any more as long as you don’t drink. Keep drinking and you most likely will have more.

  25. a girl i know, after have a 4 or so glasses of rose wine, will start to convulse about 30mins to an hour after her last sip. The fits involve fully body shakes and flailing limbs, will happen for about a minute or two, then she will go completely still. her breathing will go shallow, and then the fitting repeats. Usually once or twice before she falls to sleep / passes out.

    She only ever fits after a bit too much to drink. She has had past issues with eating disorders but is okay now, she has asthma, but nothing too serious. Her uncle has just recently died of a brain tumour, which was present from birth and only detected when he fitted. She is starting to panic thinking it is the same thing.

    If you could shed any light on the situation it would be most appreciated.

    Kinds Regards

    • Dear in need of help,
      thank you for writing in. My advise to your friend would be to abstain from drinking completely. She should bring these seizures to the attention of her primary medical doctor. A simple CT or MRI scan shall help rule out more sinister causes like brain tumors as the underlying etiology for her seizures.

      Personal Regards,
      Nitin Sethi, MD

      • Hi, I’ve been experiencing the same thing, It won’t happen often, once to three times a year, then won’t happen again for many years. It will start the same, a bit too much alcohol, then after about thirty mins I’ll get the same thing. Although mine starts off with slight hyperventilating that slowly and sometimes rapidly increases untill I start to convulse. This happened two nighta ago and two of my roomates couldn’t hold me down. I would claw or scratch anything my hands could grab onto to. They put a cold cloth and my head and it worked instantly, but as soon as I started to sleep it would happen again, The secdond time they had to put the cloth in my mouth and let me bite on it before it would stop. No amount of shaking or speaking to me would work. They decided to keep me awake. But everytme I was left alone for too long I would pass out. Any ideas?

      • Dear Emgee,
        thank you for writing in to me. My advice is that you should bring this to the attention of your primary care physician as soon as possible. Are these events which are temporally related to alcohol intake seizures or not can be determined by him based on your history and a few simple investigations. The results shall determine the treatment.

        Personal Regards,

        Nitin K Sethi, MD

  26. Dr. Sethi

    I am a 27 year guy and I had been drinking heavily since 7 years. I had my first seizure in 2007 dec when in a hospital, admitted because i was feeling very week and restless.
    I was unable to recognize things and i feared people. I thought that someone would kill me, I broke the windows of the bathroom and decided to escape and jump from the 4th floor of the building. But due to some reasons I hesitated and stand back . The security guards caught me and I was tied up.

    In the due course of time I was not able to recognize people nor the doctors nor my family members. During that time I was shifted to another hospital which was a rehab for mentally retired people. When I was moving in the ambulance I started to recall the people, and I was surprised where I was taken to.

    When I reached the hospital, I was normal. The doctors did the EEG and MRI of the brain and found it normal. I was there in that hospital for 2 days. The doctors gave me some anti- alcoholic drug and I was absolutely normal by the second day.

    Then things changed I was busy with my work, and had very rare time to consume alcohol, except during evenings and weekends. But sometimes I feel my whole body shaking if I consumed more alcohol.

    The most rare incident that happened to me was in May 2009, I was drinking heavily then suddenly I stopped. I had that fear again, that someone is after my life. I found someone was in my room, recording my phone calls, checking my mails and I was seeing scary dreams. I was running in the streets like hell. I called the police but they found no one.

    After some days I found that nothing was real. Now I fear that the hallucination lasted with me for more than 3 days. Is it the reason that I stay all alone. Have I a serious problem with my nervous system ? I had not taken alcohol since one month.

    • Dear Ferdinand,
      thank you for writing in. I am not certain what to make of these episodes of altered behavior and sensorium which you so eloquently describe. They though do seem to have a temporal relationship to your drinking and may represent alcohol induced hallucinosis or psychosis / amnestic behavior. I would do what you are doing already-abstain from alcohol completely and follow up with your doctor.

      Personal Regards,
      Nitin Sethi, MD

  27. Hello,

    My dad is 63 year old and suffered his first seizure in the middle of the night just last week. I would really like to know what may have caused it?.
    He is a definately a heavy drinker and drinks abt 180 ml of rum almost everyday before dinner. He only suffers from High BP but he also a heavy meal on the night of the seizure so I suspect may be his sugar levels might have been high.

    Now he has recovered and we have asked him to stop drinking all together . Would this be a wise course or should he reduce his alcahol intake gradually?
    I would really appreciate your help in this regard.

    Thanks,

    • Dear Solomon,
      thank you for writing in. As you may have read in my post, there can be many different causes for a seizure. I am not certain whether alcohol played a role in your father’s recent seizure. You should bring it to the attention of his doctor so that a thorough work-up can be initiated for a first time seizure episode. It is never too wise for a chronic alcoholic to suddenly stop drinking as this can precipitate alcohol withdrawal seizures. Sometimes it can lead to a condition called delerium tremens. As the name suggests, patients are delirious, have autonomic instability and can have a flurry of seizures which may be hard to stop. Also alcoholics are usually deficient in vitamins such as thiamine, folic acid, Vitamin B12 and magnesium. These need to be supplemented too.

      Personal Regards,
      Nitin Sethi, MD

  28. what causes these eposodes. i have a sister that drinks about 4 beers and she gets what we call locked jaw,this happens every time she drinks this has been happening now for several years . i had told her how she gets, so i told her the next time she gets that way i would ask her how she feel, well that day sure came , so as she was having an eposode i asked her how do you feel right now so she answered in a slurggy tone i feel numb and in slow motion like i cant talk and feels unbalanced,however this last only like a minute and shes normal and ill ask her if shes ok and shes fine and continues to socialize like nothing ever happened! im afraid something major will happen like a stroke or a major seizure or something ive told her that her body is rejecting the alcohol. she is 44 ,doesnt have a history of seizures of any kind.only when she drinks does she get locked jaw. please give me some kind of information regarding this problem. thanks

    • Dear Mary,
      unfortunately I cannot tell what plagues your sister from the history you provided. Is it a focal seizure or some sort of dystonia (spasm of the muscles of the face)? My advise would be to bring it to the attention of her doctor. A good history and clinical examination shall reveal the answer.

      Personal Regards,
      Nitin Sethi, MD

  29. My brother is 28 years old, and he has suffered from epilepsy since his early teens. He went 5 years without a seizure and then began to have them again for the last two years. He is a heavy drinker now, and though my family is convinced that the alcohol is a factor in the seizures, he has made no attempt to quit drinking. He will go several weeks without a seizure, and then the night after too much beer drinking, he will have a seizure. It is obvious to us that the alcohol is either causing or contributing to the seizures. He is very stand-offish whenever we try to talk to him about it. I was hoping to get a bit of advice about how to convince him to quit drinking and in return become seizure free (hopefully) again. I don’t want him to feel like we are ganging up on him, but with every seizure he continues to break my parents’ hearts. What would you recommend we do to convince him to quit drinking?

    • Dear at a loss,
      you face a tough situation with your brother and unfortunately a not too uncommon one. Many alcoholics deny they have an alcohol problem and feel they have their drinking under their control. My advise would be to get his friends involved in the process. You can also ask for professional help. Quitting/ abstaining from alcohol shall not occur overnight. The other problem which I have commonly encountered is that patients quit for a while only to relapse back. I wish you and your brother my very best.

      Personal Regards,
      Nitin Sethi, MD

  30. My brother is only 18 years old. About fours days ago he had a seizure. He was talking on the phone then all of a sudden he collapsed on the floor. This is when we believe he had his first seizure. When he fell he hit the right side of his face on his desk. He hit it so hard he had a black eye, bruising on his nose, and he bust his lip. My dad took him to the emergency room where he had another seizure while under their care. He is a heavy drinker yes for only 18 years old. He did mention taking some over-the-counter medication before he had his last drink. Could that have caused the seizure? Also, since he is a heavy drinker how does he go about cutting back or quitting all together without having an alcohol withdrawal seizure?

    • Dear Erica,
      thank you for writing in. I hope your brother is recovering as we speak. It is possible the combination of alcohol and over the counter medication (you did not mention what and how much) led to his recent seizure episodes. The work-up in the hospital (CT scan/ MRI scan of the brain and EEG) shall shed light on that. Usually when such patients are admitted to the hospital, we watch them closely for alcohol withdrawal. At times medication like Ativan (lorazepam) and Librium (chlordiazepoxide) are administered to to prevent withdrawal symptoms (such as seizures).
      So follow up with his doctor and they shall advise you on how to proceed further.

      Personal Regards,
      Nitin Sethi, MD

  31. Wife Susan and twin brother Brent have husband and brother in hospital for 3 weeks with one seizure 3 weeks ago and withdrawal symptoms. Has anyone had someone in hospital this long under atrivan? Hospital says could be up to 3 months before we see improvement. Looking for similar cases. Thank you.

  32. Hello,

    My wife has been a social drinker up until this January. Since, she increased her drinking. She was drinking 1 pint of vodka per day about 3 to 4 times a week in secret. When we discovered it, she did start cutting back, but she did not quit completely. She had an episode while walking the dog during the heavy period where she does not remember how she fell down and became very confused after. Nobody was there to whitness it, so we were not sure what happened. All blood work and Cat scans came back ok. In the past few weeks, she has cut back on her drinking. However, 2 days ago, she did drink heavy. At 6:00 am this morning, she had what appears to be a 4 minute seizure. She had stiffness, biting her tongue, eyes rolled back and confusion after. The ER doctor did the tests and another Cat scan and all came back OK again. We are scheduing with a nuerologist as soon as possible. Could this be alcohol withdrawl induced? She had nothing to drink 36 hours prior to this event. How is that typically treated, besides stopping the drinking? Thanks!

    • Dear Tim,
      thank you for writing in. As I stated in my post alcohol can cause seizures both when it is drunk in excess (binge fit also called rum fit) and when someone who drinks excessively suddenly stops drinking (alcohol withdrawal seizure–the seizure usually occurs 24-48 hours after the last drink).
      She needs to be evaluated. The neurologist shall determine what it the cause of her recent convulsion. This might warrant some tests like a MRI scan of the brain and EEG. Your wife may or may not need to be on an anti-seizure medication. Again this shall depend upon her test results.

      Personal Regards,
      Nitin Sethi, MD

  33. My son has an intermittent problem with IV drugs and alcohol. He’s on some medications, one of them is wellbutrin 450mg xl. He had never had a seizure before until the other day when we heard a loud crash and banging coming from the bathroom and found him violently seizing for about one minute. He told us he had just shot up cocaine before getting into the shower and thats the last thing he remembers. I think this incident is finally making him realize how self destructive his behavior is — especially when hes on other medications!
    Because he had this seizure now, is it more likely that he will have another one for another reason? A friend told me that once you have a seizure once, you’re more likely to have one again. Thanks!!

    • Dear Rob,
      thank you for writing in. It seems your son had a convulsion in the setting of illicit drug use. I agree with your friend’s assessment and would advise abstaining totally from drugs as well as alcohol. Your son should be evaluated for his recent convulsion to determine the cause of his recent seizure and what is the probability that it would occur again.

      Personal Regards,
      Nitin Sethi, MD

  34. Would you say that someone that has had alcohol induced seizure should have very fast reaction/response time? Why I ask this is, a patient post seizure was lying on a stretcher, patient lying with eyes closed, eye lids flickering, ignoring my quest for him to move a cross onto another bed. I then did a light sternum rub, patient lept up swinging and hit me to the side of the face, saying ‘you are not allowed to do that to me’. I feel he was not in a postictal state, he is aggressive towards staff whether it be seizure related or not.

    Thanks Natalie

    • Dear Natalie,
      you ask a good question. Usually during a seizure or in the immediate aftermath of a seizure (what we refer to as a post-itcal state) a patient may be agitated. During this state of agitation (the patient is thrashing around in bed), if you happen to be close to the patient (say you are tying to restrain him) you may get hit by the patient’s arm or leg. That said and done, it should not be a directed action. By that I mean, yes you may get hit accidentally if you happen to be close to the patient but if a patient reaches across and slaps you across the face, then it is a directed action and cannot be attributed to a seizure. That tells me the patient was with it and intentionally hit the staff. Moreover he vocalized during this action (“you are not allowed to do that to me” ), that too indicates that his actions were intentional and not due to a seizure. Patients can vocalize during the seizure, most of the times it is gutteral noises, not a sentence which has meaning and is directed to someone.
      Sorry you had to go through this and I hope you did not get hurt.

      Personal Regards,
      Nitin Sethi, MD

  35. Hello,

    my son has had 2 seizures in the past 6 months (6 months apart). After the first seizure he saw a neurologist and got a full checkup (cat, mri, eeg) all of which were negative. he is 27 years old and could be described as a functioning alcoholic (drinks consistantly 3-4 nights a week, has an active social life in a big city, and doesnt sleep as much as he should). the first seizure was after a big wkd with friends, a cross country flight, and occured in his sleep 24-48 hours after the wkd and his last drink. 5 months passed with no relapse, no real lifestyle change, and no medication. he just had his 2nd seizure, similar circumstances (big week/wkd w friends, drinking, lack of sleep, occured 24-48 hours last drink). after seeing the neorologist for the 2nd time he reccommended keppra weaning up to 1000mg a day. the concern is about the side effects of using this drug, could a lifestyle change be a better option (as far as cutting down drinking, healthier lifestyle, and sleeping better) or are drugs the best choice? he is not in denial about the consequences of alcohol and his situation, he just wants to know if drugs are the better choice and can one life a normal life on these drugs. also, is it common for people to use these drugs for an extended period (1-2 years or however directed by doctor), to go off these drugs, and become seizure free?

    thanks,

    • Dear Susan,
      thank you for writing in. Well your question is tricky and one which needs a long explanation. It seems your son’s two seizures were provoked: lack of sleep and alcohol. Well patients who have seizures which are provoked may not need long term treatment with an anti-epileptic drug. You tell the patient to stop drinking or drink in moderation and sleep well–and you shall have no further seizures and hence no need for anti-seizure medications. That said and done some patients have an underlying tendency to have a seizure disorder and the alcohol just brings it out. These patients may need to be on an anti-seizure medication. The answer is usually found with the help of an EEG and MRI brain study.
      As regarding the duration of treatment, that too depends upon the risks of having another seizure in the future. Your son’s doctor shall be the best person to determine and prognosticate you and him on that.

      Personal Regards,
      Nitin Sethi, MD

  36. In mid May, my 43 year old nephew graduated from a 2 year drug/alcohol abuse program. He met a wonderful lady there and have been seeing each other. She should graduate in October. Upon his graduation, he told me already intoxicated at 10:00 a.m. that while in the program, he planned on drinking again once out. He confesed to his mother and friend that he had only relapsed one time. I knew differently and unfortunately, was quiet. Three weeks ago he had a seizure and several tests were completed as well as a visit to a neurologist. Nothing indicated a seizure had occurred. Monday, he was with the rehab group at an outing, had another seizure and was taken to the emergency room again. His lady friend from the rehab facility was with him. Since a seizure had occurred just 3 weeks ago, I called the rehab facility and reported that he had been drinking, thinking that the hospital needed to know and could better treat him. This report of mine has precipitated in him not being able to see his friend and my sister being very, very angry with me. Tuesday was the lowest day of my life as I felt that I had ruined everyone’s life by telling the truth. It wasn’t until after everyone’s anger at me that I began to research alcohol withdrawel seizures. I really didn’t know they existed, I just had an instinct that it could be related. Your Website is so very important to me and I am most certain that I was correct in my instinct. All I know now is that he is on seizure medication, thank goodness! I am isolated from my family and have created many two broken hearts. Hopefully the future will hold a silver lining in this cloud.

  37. It’s been one month in the hospital for my husband from an alcohol seizure (from not drinking for 3 days and went into seizure), and one month home now. He still gets very confused about what to call things, for instance, he can describe an item, but cannot name it. He has not recovered motor skills. Still walks slowly and sometimes cannot figure out how to turn the stove on, etc. I’m worried he may not become fully recovered. I’m planning on having him re-evaluated for motor skills and possibly go on temporary disability. He does not feel he can drive yet so we took his car off the road for now. Hartford Hospital will not return my calls so I can see what his brain test results showed. This week I have an appt. with our PCP to see is she can help get the test results from the Hospital and figure out what actions to take next. Any advice what steps to take next if you feel a person is not recovering fully? The hospital said he should be fully recovered by now, but that is not the case. I’m worried for him.

  38. After reading the relationship between seizures and alcohol, I realize my situation is totally the opposite. I’ve been drinking for years, not to the point of becoming incoherent, although I do drink every day. usually vodka. I have also been suffering from a still-undiagnosed ‘seizure’ disorder. I have undertaken every test known, several times in fact, and my latest video 24-hour EEG showed yes, there is definitely something going on, but the neurologist couldnt say what, after analyzing the results. I had what appeared to be 30 seizures in 24 hours. At one point the nurse intravenously administered 2mgs of Ativan, to apparently calm me down. I am now tapering off Keppra (was taking 2250 mgs every night), and may next try Trileptal. I also take 20 mgs of Lexapro. And have most recently begun taking 10 mgs of Ambien in the middle of the night. I still have seizures that begin in the early morning hours. I can have a break-through seizure/s during the day, but not every day.
    What makes my situation different with regard to alcohol is that when I am drinking is the ONLY time I do not have seizures. Never. I thought perhaps I was having withdrawal seizures but I was in a horrific car accident at the end of June, at which time I felt an aura and then hit a tree after passing out. I was in the hospital for 4 days and didnt touch alcohol and never felt like I was ‘withdrawing,’ given the symptoms you talk about. I had a few minor seizures during my hospital stay, but never lost consciousness. So I self medicate with alcohol basically. I drink to the point where I feel totally relaxed and happy. This requires about 5 large vodkas, sometimes more, sometimes less. Then I stop. It doesnt help with the nocturnal events, and I am hoping the Trileptal will, but at least for a few hours a day, I am guaranteed to be seizure-free. What do you make of my situation?

    • Dear Kate,
      thank you for writing in. I am not sure what to make of your case and hence would defer any advise/ opinion. Suffice to say you need to have a thorough evaluation to determine exactly what kind of seizures you have, where they are coming from and how are they temporally related to your heavy alcohol use (we call this seizure characterization/ localization).

      Personal Regards,
      Nitin Sethi, MD

  39. Hello, my husband recently passed away. he was an alcoholic and also had gastric bypass in 2004 with many complications from the surgery. he was taking multiple medications, had a bleeding ulcer, and began having seizures about 3 years ago. Ultimately a seizure is what doctors are claiming he died from but my question considering the fact that he was still drinking, abusing prescription pain medications, and was in the process of having all his routine medications changed, was the seizure withdrawl related?

    • Dear Laura,
      thank you for writing in. Please accept my heart felt condolences on your great loss. It is hard to comment whether the seizure was related to withdrawal from alcohol and other illicit drugs since he had other medical conditions.

      Personal Regards,
      Nitin Sethi, MD

  40. Dear Dr,

    Thank you for offering your expertise on this blog. I hope that you may be able to advise us since my questions below have not yet been visited on this page.

    My 18YO son recently had between 1 – 2 seizures that were not alcohol related. He came down with Mono that turned into Viral Menengitus – Encephilitus. He spiked a 102.5 fever and had a seizure. He was taken to the ER and admitted. He had negative CT scans, MRI. He was given IV fluids, ativan anti-virals, anti seizure meds) The nurse on the Neuro unit said she believed that he had a second seizure later that night and he was sent to ICU. The MD said she thought that maybe he did not as the EEG was negative (after reading all of the above I can see that seizure activity does not necessarily show up). We arrived at his college town hospital the next day and he was still dopey and didn’t open his eyes.

    He fully recovered from this ordeal in three days. We kept him with us for observation for several more days and he has now returned to his studies. He is on 2000mg of Keppra daily. He will be following up with the Neurologist and I would like your help too.

    MY QUESTIONS: Does this incident make him any more susceptible to seizure recurrence, than someone who never had this happen? For how long after being seizure free can we safely feel that he is out of danger? Should he not drink at all? Do you think that because of this incident he is seizure prone?
    I am assuming that alcohol consumption while taking Keppra is not advised? How long would you recommend that he be on this medication? Thank you for any advise you can relay.

    • Dear Cathy,
      thank you for writing in to me. Let me answer your questions now.
      1. Episodes of meningitis and encephalitis can be cause for a seizure disorder later in life. This is because the disease process at times leads to scarring of brain tissue which then becomes a seizure focus (place in the brain from where seizures originate).
      2. There is no period per-se after which you can say he is out of danger. If the MRI brain and the EEG study are normal and the patient has no seizures (off medications) for about 6-12 months after the index event, you and your doctor can feel more confident in saying that likely your son shall not have epilepsy/ seizure disorder in the future.
      3. I would advise him not to drink at present as alcohol does lower the seizure threshold making him more more to having a convulsion.
      4. How long does he need to be on Keppra? Well again that is a decision his doctor shall help make. It usually is determined by taking into account his MRI and EEG findings.

      Personal Regards,
      Nitin Sethi, MD

      • Dear Dr,

        Thank you very much for taking the time to respond.

        Jason saw the Neurologist three weeks after the event and all she did was talk to him. She advised that he stay on the Keppra until the next visit in January at which time he will have an EEG. If that is negative she will have him very slowly reduce the medication.

        She advised not using very much alcohol now 1-2 drinks. Jason said he will not drink at all until he’s done with the meds as we didn’t think it was wise. And now that you are saying that it lowers the seizure threshold I feel this is cause for concern. I would very much like to have some documentation to review and to send to the MD. Can you advise me as to where I might find useful info? Any other thoughts?

        Thanks again. You are providing an invaluable service.

        Happy Thanksgiving if you celebrate it.

  41. Hello Dr Sethi,

    Again thankyou for offering your expert knowledge!

    I am 22 and do not drink regularly, however once a month when I have a drink I suffer from episodes where i feel like my whole body is shaking but its not these can last from anything from 30 seconds to 15 minutes. I just have to sit down and try to control myself- my vision is all deranged. It has happend a few times when i have not drank- it has also woke me up once. I understand how busy Drs are and do not want to see them unecessarily- so thought you might be able to shed some light!? (its only happend approx 15 times since i was 17)

    Thankyou.

    • Dear Claire,
      thank you for writing in. I am not exactly sure what plagues you. From your description, it seems you “feel” an inner tremulousness when you drink. A few questions: does this happen right after you start drinking? Is it related to the amount you drink or the type of alcohol consumed. Do you have a history of heavy alcohol consumption in the past?
      Alcohol induced tremors is a well documented disease entity. Sometimes these tremors may not be grossly visible but patients may complain of an inner tremulousness. I would advise you to consult a neurologist. A good history and examination will likely yield the answer.

      Personal Regards,
      Nitin Sethi, MD

  42. Hi, I have been drinking alot the passed year and a half. In this time I have only gone about 7-8 days straight without drinking and from time to time I go 2-3 days. But on average i am drinking about 5 days a week, and likely drink 10 shots total for about 50 shots a week(best way i can explain it). and the last 4 months i am drinking around 60-70 shots every week……My question is, am I at risk if I simply stop drinking right now, I am on my 48th hour with no alcohol and I dont feel any symptoms at all.

    My drink is SEAGRAMS 83 Whisky.

    • Dear Joe,
      thank you for writing in. My advise to you would to gradually cut down on your drinking. Alcohol withdrawal seizures are most commonly encountered in chronic alcoholics who suddenly abate drinking. Alcohol is a CNS depressant and does lower your seizure threshold. So my advise would be to see a doctor/ therapist who can help guide and monitor you.

      Personal Regards,
      Nitin Sethi, MD

  43. May I add that when I am talking “shot” i mean 1 ounce. I mix my drinks with water of diet coke, and in terms of ounes I am drinking around 60-70 a week!

    Thank-you

  44. Hello,

    I have a friend that is 45 years old. He started drinking when he was about 9 years old, and he also did drugs (speed) for 18 years. When he told me this I was amazed that a person could do this for so long (WOW) It was about six months ago when he had his first seizure. He is a heavy drinker he drinks: Vodka, Patron, and beer. He can drink the hard stuff in one day. His coloring is very dark, which I think is unusual especially in the winter, even though he is Hawaian he still looks too dark. Now after he drinks for several days and stops he has these seizures. Last week though he was drinking a beer, and was outside with friends, then proceeded to go into his home, and had one. He has been having these seizure alot lately, and I am concerned, but one thing he will not go to the doctor; he makes excuses not to go, and he will not let anyone take him.

    Please tell me what I need to do? He will not let anyone help!!!!!!!

    • Dear Racr,
      thank you for writing in. Your friend seems to be in denial of his alcoholism and of his medical condition (seizures). Maybe you can get other friends or his family to intervene. My advise to you shall be not to confront him, rather gently yet firmly coax him to see a doctor.
      My very best to you in this endeavor.

      Personal Regards,
      Nitin Sethi, MD

  45. I am twenty years old. I tend to have what I can only imagine are alcohol-induced seizures. The frequency of them has increased, especially since I have not cut back on my alcohol intake. However, these “fits” can last from a few minutes to even over an hour. They usually involve violent shaking, uncontrolled biting down, and thrashing about. Sometimes I am conscience during the episode, sometimes I am not. My eyes usually roll back in my head. I broke my toe when I kicked a wall during one of these episodes. How can I be sure these are alcohol-induced seizures, and should i discuss them with my doctor?
    Thanks.

    • Dear Anna,
      thank you for writing in. Yes you should surely bring these episodes to the notice of your doctor. Relatively simple tests which involve a good history, physical and neurological examination and an EEG (electroencephalogram) can help determine the correct etiology of these violent spasms which plague you.

      Personal Regards,
      Nitin Sethi, MD

  46. I believe i had a pretty sever alcohol with drawl induced seizure yesterday …. basically what happened was i cam too already standing in my kitchen but really had no idea where i was at all… i hadnt had a drink in 36hrs and it took me a few mins to even realize where i was.. which its not right… and both sides of my toungue are swollen like my mouth just clamped on it and my back is soooo sore like it seized up i am thinking.. are these after affects of a seizure and should i go to the doctor…

  47. Hi Dr. Sethi,

    I am a 20 year old bodybuilder and have had 2 seizures, one about 1.5 years ago and the other about 2 weeks ago. Leading up to the first one, I was taking ephedrine and caffeine as part of the “EC” stack which is popular for fat loss. The day before I had about 6 drinks. I woke up the next morning hungover and took 200mg caffeine and 25mg ephedrine sulfate (bronkaid). About 4 hours later I woke up in an ambulance. I didn’t remember anything or have any warning signs.

    The second seizure is relatively the same story. This time however, I was on a cycle of clenbuterol. The morning before the incident I took 60mcg of clen. That night I had about 10 drinks. Next morning I woke up hungover, and about 3 hours later woke up in an ambulance, having remembered nothing, and having had no warning signs.

    I know these happened because of mixing alcohol and the ephedrine/clen but I was wondering if you have any thoughts as to why? I have binge drank quite a few times (with no ephedrine/clen) and not had any problem. Is it something having to do with being dehydrated/electrolytes depleted the next day?

    Thank you!

    • Dear Brady,
      thank you for writing in. I feel your seizures have been likely provoked by this cocktail of alcohol and ephedrine/clenbuterol. I have seen this before. My advise to you shall be to bring these episodes to the attention of your doctor. Till then it shall be wise to abstain from this cocktail.

      Personal Regards,
      Nitin Sethi, MD

  48. I come from a long line of drinkers, and i have suffered 3 seizures in the past six months……i have never had one before then…….im 24 and started drinking alot when i was 17……..as soon as i turned 21 i drank all the time when i could. Every day after work it would be a 12 pack or a 750ml of E/J……when i had a “seizure” i wouldnt remember any thing when i came to….my friends say that my whole body tensed up and i was stiff as a board for like 3-4 mins…….I had know idea where i was or even what year it was when i came out of it……….Q….Is this a seizure or something else?????

    • Dear Elsixstrings,
      as you describe your symptoms, seizures do come foremost to my mind as the differential diagnosis. My advise would be to bring these episodes to the attention of your doctor at the earliest. Cutting down on your alcohol intake shall be the first step in the right direction. I send you my very best.

      Personal Regards,
      Nitin Sethi, MD

  49. Dear Katen,
    Simple snoring is quite common during pregnancy and usually resolves once the baby is delivered. My advise to you would be to consult a sleep specialist (either a neurologist or a pulmonologist with specialty sleep medicine training). Some relatively simple sleep tests such as an overnight sleep study (polysomnography) shall yield the answer to your snoring issues. The treatment is tailored to the cause.

    Personal Regards,
    Nitin Sethi, MD

  50. Hi, Im 22 years old, and I do binge drink on occasion, then will go cold turkey from anywhere to a week to a month. After I go off the binge, I do get the usual withdrawal symptoms (shaky hands, thirsty, sweats, anxiety, etc.)for about a day-2days. I have already had anxiety before I started drinking(age 17). My anxiety is amplified after these binges however, and I heard about these alcohol withdrawal seizures and I began freaking out that I may get one. I’ve never had one before in my life, and I was just wondering how long after these binges is it possible to go into a seizure. My New Years revolution is to not binge anymore and just have a couple of drinks here and there, so I wont have to worry so much, but if you could shed some light on this it’d be greatly appreciated. Thanks, for your time.

  51. 35 y/o m with no significant medical hx has been a chronic binge drinker since the age of 20. Alcohol intake has increased more through the years (1-2 pints of whiskey 3-4 times/week including minimal beer intake). 3 years ago after a weekend of binging, which included cocaine, he had his first clonic-tonic seizure (that was witnessed). ER doc said it was d/t the cocaine. Since then he had stopped using cocaine but continued to have seizures after binging. It has been 3 years of multiple untreated gran mal, partial and/or focal seizures. It mostly happens a few days after stopping the liquor and/or when sleep deprived.

    One evening while driving and NOT drinking, he crashed his car and does not remember any of it. At this point he has stopped drinking. 20 days clean and has had 1-2 focal seizures during sleep. How long does AWS last? Do you think his brain is affected by having so many untreated seizures? Should he get on anti-epilectic meds? If these are provoked seizures will an EEG even be worth it? The family has no history of epilepsy. Will his driving be affected? As a physician, do you have to report to the state if someone has provoked seizures or would this be a HIPA violation? Does taking the recommended dose of Nyquil have any affect on provoking a seizure during withdrawal? Would he have a high risk of reoccurrance?

    Thank you for your time and advice.

    • Dear Tina,
      thank you for writing in. You ask specific questions and hence I shall answer them likewise.

      Q: How long does AWS last?

      A: acute alcohol withdrawal seizures occur about 24 to 48 hours after the last drink. Delirium tremens (during which the patients may have a flurry of seizures) peaks 72 hours after the last drink. We usually like to put patients on Librium or Ativan (lorazepam) to prevent AWS till we see no signs of autonomic instability (such as variations in blood pressure and heart rate), tremors and so forth.

      Q: Do you think his brain is affected by having so many untreated seizures? Should he get on anti-epilectic meds? If these are provoked seizures will an EEG even be worth it?

      A: while there is no study which clearly shows that the brain is damaged by seizures permanently (and I do not mean status epilepticus–where in neuronal death does occur unless seizures are controlled quickly), ongoing untreated seizures certainly are not desirable.
      Whether he needs to be on long term anti-convulsant is a question that can only be answered after reviewing his history at length and after taking into consideration test results such as EEG and MRI brain.
      We are assuming his seizures are provoked. It is also possible that he has an inherent epileptogenicity and the alcohol brings it out. Also during this long history,. he may have fallen and now have a secondary seizure focus in the brain. So yes the EEG is worthwhile.

      Q: The family has no history of epilepsy. Will his driving be affected? As a physician, do you have to report to the state if someone has provoked seizures or would this be a HIPA violation?

      A: The laws with respect to driving and epilepsy vary from state to state. In the state of NY where I practice, I am NOT mandated by law to report to the DMV (department of motor vehicles) that my patient has a seizure disorder. All I have to do is tell the patient that the law in NY is that ” you have to be seizure free on medications for one year before you can drive”. I do this and I document in the chart that I told the patient about not driving. It is left to the patient’s own good judgement that they shall heed my advise and not drive. In the state of NJ, the physician is mandated by law to report this to the DMV. The duration of time you have to be seizure free before you can drive also varies from state to state. The DMV website or the American Epilepsy Society website are good resources for more information.
      Now suppose you come to know the patient is still driving (inspite of your advise). Moreover he is driving a school bus. What do you do then? Hmmm tricky and messy situation. Lives are at stake here. I shall confront (maybe not confront but approach) the patient with this information. If he still continues to drive, my responsibility to the public at large exceeds patient confidentality (HIPAA privacy rules). I can then approach the DMV directly.

      Q: Does taking the recommended dose of Nyquil have any affect on provoking a seizure during withdrawal? Would he have a high risk of reoccurrance.

      A: many medications can lower seizure threshold. I would double check on all his medications to see if he is taking anything which lowers his seizure threshold. The risk of recurrence can only be determined after a detailed history and taking tests like EEG and MRI brain into consideration.

      Hope this helps.

      Personal Regards,
      Nitin Sethi, MD

  52. My mom (47 y.o.) had her first seizure last Friday while driving a school bus. Thankfully no one was hurt. She has a long history of alcoholism and has since married an alcoholic, so her drinking has progressively gotten worse. During her first seizure, she lost control of her bowel movements and began to foam at the mouth. She was immediately taken to the ER. All tests came back OK, except for the MRI which showed a spot on her brain. They discharged her that evening and encouraged her to make an appointment with a neurologist. On her way home, she had 2 more seizures. So 3 in about 6 hours.

    I have explained to her that she can die from the seizures if they aren’t properly treated or develop a TBI. She did not tell the physicians that she is an alcoholic, just that she drinks. She is in denial about her drinking and the linkage to the seizures. She believes that they are not connected because she hasn’t had a drink in a week prior to the seizure (unsure if that is true).

    She is aware that her license will be revoked and she therefore will be without a job. Any suggestions as to how to help her come to a realization about her drinking and seeing a physician about her seizures?

    Thank you!

    • Dear Dana,
      you face a difficult situation indeed. Well here is my advise: harsh though it may sound. Seizures can kill and the fact she drives a school bus there are other lives at stake here. So if you really care about her, you should bring your concerns to the notice of the concerned authorities: her physicians and the DMV (department of motor vehicles).
      She needs help and she should NOT be driving till her seizures are fully under control. The laws with respect to driving and seizures vary from state to state. Act on this now, else you shall regret.
      Personal Regards,
      Nitin Sethi, MD

  53. Dear Dr. Sethi,
    I am a 40 yr old alcoholic, “heavy” drinker for 20+ years bourbon and beer nightly. I quit drinking late September about 72 hrs after I had a seizure and was in ICU for nine days. I have no memory of the seizure or the nine days following. According to my wife I was alert during the hospital stay but unable to write or walk and had slurred speech which has drastically improved. There was damage to my jaw and rt leg from the muscle spasms. The leg is better but I still have pain while opening my mouth. I continue to have a difficult time remembering some simple things but hope that will continue to improve. My problem is I have lost interest in sexual activity and unable to get an erection since. Pre seizure I had a healthy libido desiring activity almost daily and now it seems nonexistent. Could the lack of sexual desire be in any way related to the seizure? I am still sober but frustrated with this situation. Any help is greatly appreciated.

    • Dear William,
      you should not have lasting sexual dysfunction after a seizure. I would have sure the medications you are taking are not causing this loss of libido. Many medications including some seizure medications and anti-depressants cause loss of libido in males.

      Personal Regards,
      Nitin Sethi, MD

  54. My sister, Kay, has been an alcoholic for many years. In December 2000 she had a series of seizures / strokes which left her with short term memory issues, diagnosed as Korskoff’s Syndrome. Since that time her family moved her from FL to NYS and she mainly resided in adult homes (2 different ones). At both she has still been able to access alcohol and in the last 12 months (Dec 2008 to Dec 2009) she has been hospitalized five times with seizures.

    All of the seizures have followed a period of drinking during withdrawal. For the last two times we have requested a blood alcohol level test upon hospitalization. The first of these reflected a very low level of blood alcohol and the last reflected no alcohol in her blood.

    Question:
    Is it possible that the alcohol has completely left her system and she still seizes or is something else going on? Should she been seen by a neurologist? Are there neurologists in our geographical area (Rochester NY) who specialize in the issues of alcoholics?

    We would appreciate any thing you could add that would help us determine how to proceed. Thanks,

  55. Hi.

    I’m 52. I usually have around 10-12 pints over a weekend and maybe one liqueur. I drank about -76 units a day over Christmas and New Year then had a week without drinking.

    I went for a meal on the Saturday night, had 3 pints and a meal of venison.

    Afterwards I felt a ‘stiffness’ in the index finger of my right hand. I have had this before but after a minute or so it has gone away. This time it spread to my thumb and the next thing I knew I was waking up on the pub floor. According to eye-witnesses I was out for about 2 minutes but breathing normally (no spasms).

    There was no pain at any time (stiffness/tightness yes, but no pain) but I was aware that I might be going to pass out!

    I was taken to casualty and the doctor said I had had a seizure (my first). he said it was definitely not heart or blood pressure that had caused a problem.

    What type of seizure did I have and was alcohol the likeliest cause?

    Do i need further treatment? – the Doc said it is normal to wait six months to see if a second one occurs.

    I’m frightened to drink a glass or two of wine/beer, but in a way I am scared not to as well – I’ve read withdrawal can be dangerous!

    Any response would be gratefully appreciated!

    Thanks for your time reading this, it was all a bit scary. Happily I have been able to sleep fairly normally since.

    • Dear Jim,
      thank you for writing in to me. It seems you indeed did have a convulsion. From what you describe, it is likely related to your excessive consumption of alcohol. Do you need further treatment? You need to be evaluated a tiny buit further. My advise to you would be to follow up with your PCP. He/she may refer you to a neurologist who shall be the best person to determine whether your seizure was actually induced by alcohol or not or do you have underlying epilepsy. Further work-up like a EEG and MRI scan of the brain may be warranted, but the answer always lies in a good history.
      I wish you my best.

      Personal Regards,
      Nitin Sethi, MD

      • Hi Nitin

        While awaiting further examination I have developed one or two other symptoms that may or may not be related, and I was wondering if you could comment?

        both my wrists(towards my pinkies) have become occasionally weak and every now and then I get a sort of numbing twinge as though two blood vessels are momentarily overlapping.
        I mention this because I gather the vessels come from the neck, where I have sensed a lump in the middle back (fractionally left of centre if anything) of my head, about the size of a large pea – and i wondered if there might be a blood clot or lymphoma putting pressure on the ulnar nerves for example?

        I’m not aware of having bumped my head there at any time.

        Thanks, sorry for posting again but can’t help being concerned.

        Jim.

      • Dear Jim,
        thank you for writing in to me again. Glad to know you are well. I am not sure what is the cause of your current symptomatology. I doubt it is a blood clot or a lymph node pressing on the ulnar nerve. You say lymphoma, do you have a history of lymphoma?
        The ulnar nerve arises from the brachial plexus. Your numbness/ weakness localizes to the C7-C8 nerve root. So either you have a lower cervical radiculopathy (would be unusual to have bilateral lower cervical radiculopathy though). The other possible explanation is that you have a neuropathy (may or may not be related to your history of alcohol intake/ nutritional deficiency).
        My advise would be to bring this to the attention of your doctor. He/ she can then guide further work-up.

        Personal Regards,
        Nitin Sethi, MD

  56. Hi Dr. Sethi,

    I’m a 34 y/o male who had a atonic seizure a month ago. I have no prior medical issues and no one in my family has ever had a seizure. Prior to my seizure I had a been sick for about a week with a very bad cough and run down a bit. My wife recently gave birth to a child around this time so I guess to some extent I may have been sleep deprived. The day of my seizure I had taken robitussen DM, a Z-pac and a skelexan (muscle relaxer), all three within a span of an hour with very little food or fluids. After taking the medication I went to lie down on the ground as I was feeling a bit tired. When I woke up, I recall not feeling well and went to the bathroom to throw up as my stomach was bothering me. I did not throw up but remember feeling very light headed, I told my wife this and the next thing I knew my wife and mother in law were standing over me. My wife told me I passed out and my eyes rolled back and the my arms were raised with my mouth closed. After about 30 seconds I woke up and I just remember being very thirsty. I was taken to the ER and had a CAT scan, MRI and almost hrs of Video EEG; with everything coming back ok. In speaking my neurologist he said the likelyhood of this happening again in my life is 30% as my body as show under the right conditions (worn down, sick, dehydrated, all three meds) I can have a seizure.

    In the past I have been a binge drinker, however only drink probably once a month now but when I do drink its usually 8-12 beers and smoke a few cigarettes. I have not drank in almost 2 months and after reading your posts on alcohol and seizures and am curious as to if you think I should avoid alcohol all together or is it okay to drink in moderation (2-3 beers).

    Many thanks

    Mike

  57. I should have said in my last post that it referred to the very first piece by Nithin Sethi MD. He does go on the say that there should be medical supervision.

  58. hi, i have had 4 seisures. they were spaced out between months. they were because of alcohol. They happened the next day so i assume they wer alcohol withrawal seisures. The ting i dont get and the doctors cant explain is that why dont i hav a seisure everytime?i mean i went out a month ago and had a serious amount to drink but 2 weeks ago i only had 6 cans and had a seisure the next day. i am really worried as i cant enjoy a drink without worrying. Its so annoying because i have had a mri, eeg and so on and still the neuroligist tells me that there is nothing he can do. Is there anything i can do to seek further help?

    • Dear James,
      thank you for writing in to me. Like I explained in my post, alcohol lowers the seizure threshold. Meaning that if you have an underlying tendency to have a seizure, alcohol shall bring that out. No one quite knows how much alcohol is needed to trigger a seizure . It likely varies from person to person. Also not all seizures occur at the height of binging. You can have a seizure when you drink too much (alcohol intoxication), you can also have a seizure when you suddenly stop drinking (alcohol withdrawal seizure). So James if you drinking heavily on a daily basis and you stop drinking suddenly, you risk an alcohol withdrawal seizure. My advise to you would be to see a doctor. Under his supervision you can taper down your alcohol consumption gradually.

      Personal Regards,
      Nitin Sethi, MD

  59. Hopefully you’re still answering this.

    My friend a few hours ago informed me of a suspicious situation involving her sister. Around 10 pm, my friend arrived home from work to hear some gurgling noises coming from the shower. She then discovered her sister having what looked to be some sort of seizure. Her sister has never had this problem before. She rushed her to the hospital and they did a few tests and discovered her blood alcohol level was four times the normal amount. The police did a search of the house and discovered no evidence of alcohol intake. She was supposedly fine before 10 pm. According to my friend, she is not a heavy drinker and has not had a drink in about a month.

    Is it possible for the alcohol level in a person’s blood to rise spontaneously? She is not on any medications as far as I am aware and no one has been able to explain a thing. She is still unconscious and has not been able to answer any questions. The police say her car has not been moved. Everyone is confused.

    This is a very peculiar situation. If you have any suggestions as to what might have triggered the seizure, please share it! I eagerly await your reply.

    Regards,
    Sarah

    • Dear Sarah,
      thank you for writing in to me. Hmmm quite the mystery. Alcohol in a person’s blood has to be exogenous in origin meaning that the alcohol has to be ingested/drunk or injected into the body. Her seizure/ convulsion may or may not have been triggered by alcohol. As a work-up for her new onset seizure, your friend’s sister may warrant a few basic investigations namely an imaging study of the brain such as a CT scan or a MRI and an EEG (electroencephalogram). A good history from the patient shall help her doctors determine if her recent seizure was provoked by alcohol or not. As to how the alcohol got into her system I have no clue. The patient shall be the best person to answer that question once she regains consciousness. I wish her a speedy recovery.

      Personal Regards,
      Nitin Sethi, MD

  60. I suffered my first seizure just over a year ago the day after a night of drinking at a party and was told by doctors that i had suffered a tonic clonic seizure. I would also like to add that i was going through a time of stress when i experienced the seizure.
    Since then i have drunk a fair amount on nights out and would say i have been drunk on numerous occasions yet not experienced any problems or had any fits. However, a few months ago i went to a party, after a stress filled week and drank quite alot that night. The next day i suffered a seizure.
    Since then i have had the occasional glass of wine and been fine the next day. Is there any chance i could be allergic to alcohol? Could you please enlighten me on my situation and give me some advice?
    Thank you

  61. Hi,

    I thought that I would let you know about the Seizure types that I have so far come to and Understood within myself:

    At least 16 kinds of Seizure Triggers that I know of

    1. Tablet Delays

    2. Low in Fresh Breathable Air

    3. Overwhelmed or Shy Crowded Mind Times

    4. High Temperature Changes Going on in or through me via Weather or other causes

    5. Other Temperature Factors Going on in or through me with Dry and Thirstiness Conditions Staying Remained in me and Ignored by me, in me not getting myself a Drink Quick Enough for many Reasons like for example, I’m Relaxing in Bed and I cannot be bothered getting up to get a Drink and Disturb my Current Comfortable Bed Peace, But was unaware or Did not Expect to get a Seizure instead Due to Heat and Dryness Factors of Dehydration

    6. Hardly any Sleep

    7. Other bad breathing consumptions

    8. In an overload of distressing panic or shock shaky times

    9. Drinking Alcohol

    10. Looking at bad bright sunlight or bad bright light in the dark

    11. Low in standard health balances and energy

    12. Getting very or extremely unsettled via nightmare movies

    13. Over using myself on game thinking and stress concentrations

    14. Over pointing, sticking and gluing my eyes directly at 1 small part of a computer monitor without allowing them to freely move in any flexible way or form

    15. Getting hugely growled at then feeling very high scared and nervous afterwards that I cannot direct myself in any way or form to escape the trouble or distressing stressful time away from the risky boss, because then my eyes just sit in single places with my mind full of stresses for long times and my mind easily gets overpowered by all that with a seizure forming and crawling like a stressful dig around in my brain wires

    16. Taking tablets on a close to normal bases, then heading into taking them on a totally far away occasion, or sticking to a balanced pattern for a while or long term, then breaking the pattern apart is another way that I can seem to cause me seizures

    Kind Regards’
    Michael

  62. HI, i spent five days in hospital after what appeared to be a Seizure. On the days leading to this i had been experiencing a severe headache and episodes of confussion. ( unable to answer people , feeling spaced out ) I never considered myself as having a serious drink problem ( 25 /30 units per week ) but was informed by the Nuerologist that ALCOHOL was the cause of these episodes of confussion and he was not totally convinced it was a full Seizure … ? I had a CT scan , lumber puncture , MRI etc , all of which were okay !!! I was advised not to drive which affects my ability to work at my present job and i am worried that his will have an impact on my search for alternative employment. Having read through most of your E-Mails i am coming to terms with my condition being down to Alcohol as surprised as i am. I have found the Website very informative and a bit of an eye opener regarding all aspects of Alcohol and the problems it can cause. Thank You ! Ps , Wouid drinking Redbull on a daily basis ( 3-4 cans ) have contributed to my assumed seizure or episodes of confussion caused by HIGH BLOOD PRESSURE ?

  63. Hi; I wanted to read up about alcohol induced seizures because I have a question(s) for you, but I guess I should give you a little background first. I have had 7 of them, never had a problem before. The first one I do remember…I was drinking heavily ( Vodka ) and had done some recreational drugs too. I was in the kitchen and my bottom jaw “stuck” out and my hands clinched tight! My brain said “lay down” so I did and that’s as much as I remember. My soon to be wife and my son told me that my lips turned blue, eyes rolled up and I “wet” myself.Needless to say they called 9-11 but I refused to go.The other 6 six I do not remember…although the last one happened in the street and I got 3 staples in the head as a result.My Dad was an alcoholic so I never really drank growing up.However,when my son’s mother and I split when he was 2 ( he is 16 now ) I started to drink more, I had socially here and there but not like this.The seizures started about 3+ years ago I would “guesstimate”.I tried rehab 3 times – no good.At my “peak” I was drinking a gallon of Vodka a day.( I am not making any of this up! ).I have had massive panic attacks,spent hours ( every 20 min.) over the toilet,my blood pressure was through the roof and on and on.The “nail in the coffin” for me was one day I had my “other half” leave work to bring me my fix because I couldn’t handle the with-drawls any longer that morning. I drank about a pint and had pain in my chest,irregular breathing and I honestly felt like I was going to die!!My neighbor took me to emergency.When my “other half” got wind of it and showed up I was in horrible shape. The Doctor told her my blood-alcohol was .335 and he wanted to know how come I was even still functioning.( I know nothing of the point scale but I assume that was pretty bad ).I spent 3 days there, 2 on a heart monitor.They gave me Valume ( I don’t think I spelled that right ) and I don’t know what else.I had been given Librium in the past but they did not give me any, nor did I have any seizures while I was there.I was however really scared.When I came home I swore to my family that that was it……..it will 2 years in April !!! I drink a lot of coffee ( w/milk and sugar of course )and I like my ice cream!I build and paint models to “occupy” myself around the house but I do still think about it ( drinking ) here and there.I’m really not to worried about starting again…all I have to do is think about what I put the people I love through and that pretty much ” kills ” any craving,but I am fully aware that I will always be an Alcoholic. I do have an excessive personality, I really can’t do anything in moderation and I have insomnia ( in other words I am VERY high strung to begin with ).I will say that life is sooooo much better now but I do have a couple of questions……Why all of a sudden? 20+ years of “partying” and then one night “boom”( or did I answer my own question? ).It did take awhile to get to a gallon a day ( a few years in fact ). On a bigger scale….what I really would like to know is am I done having them? I think about them once and awhile and it kind of scares me to think I could be out doing something and have another one.I abstain from alcohol and everything else, but I do miss being able to “socialize” like everyone else.I don’t mind when people drink around me, it doesn’t tempt me or anything ( plus I know what they are going to feel like later! ) but I guess I put myself in that “boat”. Am I done having them??? I haven’t had one since I stopped drinking although one night at work shortly after I stopped I did have some kind of “panic attack”( light head,scared,sweating,dizzy-I just went home ) been O.K since but that is what got me wondering if I am truly done w/them.( I cannot associate any pain or anything w/having them – just waking up disoriented in an ambulance or wherever else, but again….I am clean and sober and will stay that way so can I assume that there won’t be anymore?
    And to anyone reading this….I am no expert on this and believe me, I don’t tell ANYONE how to live their life but – if your to the point of having seizures from drinking like I did – time to quit the game and walk away! I was playing a game that almost cost me my life – wasn’t worth it!
    Thank you for your time reading this and I look forward to your response.

    • Thank you for taking the time to write this. Also, thank you to the good doctor who wrote this article. I had my second (alcohol induced) seizure last night & I will never drink again. I don’t think that I have an alcohol problem as I have never had withdrawal symptoms, don’t drink everyday, never drink before 5 or 6 in the evening and don’t feel a general need to “have” to drink. I do however enjoy drinking very much & until last night, I thought that my first seizure was caused by benadryl. Now I have put it together that the alcohol was the connecting factor. Also, I was drinking vodka last night and I don’t usually drink that. I really hope that others who are reading this will also stop drinking. My life & my family are worth so much more than me having a drink. Thank you again, as I am now positive that my seizures have been alcohol induced and will never touch alcohol again.

  64. Hi there,

    I thought i’d post my story.. I think I have a good handle on what the cause was but I will describe it here in the case that it helps someone in the same situation.

    I had a seizure about 2 weeks ago.. my second seizure – the first was 6 years ago.

    I had an MRI and EEG the first time, all came back clear. Now waiting to have the same done again.

    I haven’t been sleeping very well for a few months. I was staying away with work and ended up staying up all night drinking with a colleague, must have went to bed about 6am and had to be up for work at 8am the next day. That was an extremely long day.. to say the least.

    During the day, I had noticed peculiar spells, particularly with my vision. Then at one point i noticed a strange smell, I didn’t ask anyone at the time if they could smell it but I reacted strongly to it and no one else was reacting, so I assume it was just me. I have assumed I was having alcohol related symptoms. I soldiered on through though, not releasing I was probably experiencing auras – i’d never had these symptoms before.

    Something else about that day; I was off my food. This is really unlike me, but I just didn’t feel hungry and didn’t bring myself to eat. Maybe this caused blood sugar to be abnormally low. Also, I was a lot more stressed than usual with my situation at work.

    Normally, I am thinking that I experience all these things (triggers) – all the time and do not have seizures.. for instance i’m always tired, I can’t turn my brain off at night! I often have a heavy session with regards drink too and a combination of these two. However bringing together maybe 4 triggers (no sleep, alcohol, stress and lack of food) is what caused the 2nd seizure.

    The only links I can find between the first and 2nd are that:
    They both happened during sleep
    I had strong feelings of guilt both times (could that in itself be a trigger?)

    First time: there was no drink.. my sleep was ok.. I was feeling guilty though.. so maybe it is strong emotional stress that brings on my seizures.

    My physician wants to put me on meds but I am resisting for now – at least until I have the results from the next scan/EEG.

    • Dear Steve,
      thank you for writing in. I am posting your comment, hopefully it shall help someone else. Take good care of yourself. I send you my very best.

      Personal Regards,

      Nitin Sethi, MD

  65. HI
    My Father is an aolcoholic and last Sept he was admitted to hospital after a fall when drunk – whilst in hospital he had a fit – understandable he was cold turkey whilst there. He was treated and sent home. Since Dec he has reduced his drinking and now generally consistantly drinks 1 bottle red wine a day – yes this is still too much but about 50% what he used to drink – he reduced gradually and has maintained this intake for a few months now.
    What I find strange is that all i can find about these alcohol withdrawl fits relates to 2-3 days without alcohol – Dad had a fit a few mornings ago after a normal day and normal alcohol consumption levels. The hospital saw alcohol in his notes and packed him off home again with some Vitamin B tablets.
    How many alcoholics normally get fits whilst they are still drinking? How normal is this? He is eating better these days than he was but still could do with eating more. He borderline underweight and 74 years old – he has been dependant for more years than I can imagine but probably the last 12 years have been the worst. He does not drink in the morning but the first drink in the day is normally 3/4pm and last drink 6/7pm before bed. This one bottle of wine is often enough for him to fall when on his way to bed or even a few hours later I have had to carry him back to bed if he falls in the bathroom. His body just doesnt seem to be able to cope with alcohol any more – less alcohol to get drunk – is this why he is having the fits?
    My apologies for long winded questions but the question needed some context to make sense I think. Any I am not delusional about his alcohol intake – I monitor it and he has no other way or place to stash any.

    Thank you so much in advance

    • Dear Tess,
      thank you for writing in to me about your father. There is no one set limit above which alcohol can induce a seizure. The limit varies from person to person. Rum fits (seizures which occur at the height of binging) of course occur when one consumes too much alcohol in too short time. Alcohol withdrawal seizures classically occur 24-48 hours after the last drink (they occur in people who are chronic alcoholics/ people who consume heavy alcohol on a daily basis and who then suddenly stop drinking). Again not every chronic heavy drinker gets alcohol withdrawal seizure if he/she stops drinking suddenly. Usually it is the person who is chronically malnourished and dehydrated who is more predisposed to an alcohol withdrawal seizure in the setting of sudden cessation of drinking. These people as you can well imagine are deficient in multiple vitamins and minerals (commonly the B group of vitamins such as Vitamin B1, B2, B6, folic acid and B12). Their electrolytes are also more likely to be off (meaning they serum sodium, potassium, magnesium is low). They may also have alcoholic liver disease (alcoholic steatosis or fatty liver, alcoholic hepatitis and finally cirrhosis). During their prolonged drinking years they may also fallen down and struck their head. So it is a combination of factors (meaning the overall health status) and not just the sudden cessation of drinking which predisposes some alcoholics to alcohol withdrawal seizures.
      Finally over the course of years of heavy drinking, some alcoholics develop epilepsy. The reason for this may be any of the above I have listed. My personal feeling is that these patients likely have underlying epilepsy and alcohol (in excess or sudden cessation after years of drinking) just helps to unmask it.
      Now let me answer your last question about time frame of recovery. Again if his pre-existing neurological status is compromised (his memory is already bad after years of drinking, his general medical condition is poor or if he has coexisting medical problems such as chronic lung or liver disease, diabetes or congestive heart failure) his recovery from a convulsion shall be slow as compared to a young person with no pre-existing medical problems.
      I hope I have addressed some of your concerns. I wish you both my very best.

      Personal Regards,

      Nitin Sethi, MD

  66. Dear Mike,
    thank you for writing in to me. It is hard for me to say here if your seizures are related to alcohol intake or whether you have underlying epilepsy and the seizure is a manifestation of the same. That differentiation is usually made after taking a thorough history, a detailed neurological exam and after reviewing the results of tests such as MRI brain (usually with and without contrast) and EEG (the yield of a routine 40 minutes EEG is low and at times specially if the index of suspicion is high, your doctor may request a prolonged 24 hour EEG study). Only after that can one prognosticate about alcohol intake.
    In the meantime it shall be prudent not to drive (NY State law is that you have to be seizure free for one year before you can drive) and also to avoid alcohol altogether.

    Personal Regards,

    Nitin Sethi, MD

  67. What an interesting thread. I thought it might be useful to some of you to share my experiences.

    When I was 21 (I am now 48), I sufferred a Sub arachnoid haemmorage which was successfully clipped. The only after-effect was epilepsy which calmed down to no fits after a couple of years. I have been fit free for 25 years. The fits I experienced had no warning or aura.

    Over the last 4-5 months I have experienced 4 bad fits with a weird aura feeling beforehand. These were all following heavy spirit drinking sessions and I have now decided not to drink wine or spirits and stick to a few beers which had caused me no problems since the operation at 21 yrs old. I am fairly sure the recent heavy intake of spirits has triggered this recent problem. Perhaps along with a stressful job and drinking culture which came with it was also a problem? My drinking could have been as much as a bottle of spirit the day before the seizure.

    Anybody with a similar experience? It would be nice to exchange thoughts. I* would also welcome comments from any neuro trained people here.

    Jerry

  68. Hello Dr Sethi! To begin with, I’d like to thank you for clarifying and educate us about seizures.(esp. rum fits, alcohol withdrawal seizures and Dts seizures)

    I have some questions:

    1. How would I differentiate between epilepsy and alcoholic fits? Ignoring any test(EEG,CT), i mean based on the clinical manifestation?eg. duration of fits?the sequence of occurence (pattern of seizure)?etc…

    2. how would i differentiate between epilepsy and the ‘fits’ that is seen in patients with hysteria (conversion disorder)?

    3. is treatment necessary for alcohol fits? or just allow the patient to relax in the recovery position and let the fit go away?

    4. how would you distinguish between: alcohol withdrawal syndrome and DT? is there any special cardinal symptom that will give me a clue that the patient is in DT.?

    Thank you very much Dr Sethi. looking forward to hear from you.

    Dr. Ronny Gooriah (doing Internship)

    • Dear Dr. Gooriah,
      thank you for writing in to me. I am glad you found the information presented useful. Now without further delay, let me answer your questions.

      1. If I understood your question you want to know how to differentiate between seizures caused by alcohol (alcohol fits) from seizures/epilepsy caused by other conditions. As you may be well aware of, epilepsy is a condition which predisposes the patient to multiple convulsions in his/her lifetime. There are numerous causes of epilepsy. Broadly speaking epilepsy can be idiopathic , symptomatic or cryptogenic. Seizures may also occur secondary to a medical condition which may or may not involve the brain like for example a brain tumor, head trauma, meningitis or encephalitis and in the setting of multiorgan failure such as sepsis, renal or hepatic failure. There is no absolute way of differentiating a seizure caused by alcohol (excessive use or sudden stoppage) from epilepsy (whether idiopathic, symptomatic or cryptogenic) specially early in the course of the disease. One needs to take a thorough history which should include a history of alcohol intake. How much? what kind? over what time frame were the drinks consumed? were drinks mixed? were recreational drugs taken along with the alcohol and so forth. Other history which may be helpful in determining if the patient has epilepsy include: a history of febrile convulsions, family history of seizures, history of meningitis or encephalitis, history of significant head trauma and if seizures have occured in settings where the patient was not abusing alcohol. The answer to all these questions and the results of tests such as EEG and neuroimaging (MRI brain) shall help in determining whether the patient has epilepsy per se or whether all his seizures can be attributed to alcohol.

      2. Nonepileptic events (pseudoseizures) may occur as a manifestation of a somatoform or conversion disorder. These patients have events that look like seizures (sudden shaking of the body and the patient may appear to suffer loss of consciousness) but there is no EEG correlate to these events. Meaning that the EEG shows the patient is not having a seizure. Patients who exhibit nonepileptic events (some doctors refer to them as hysterical convulsions) usually fall in two categories. Either they are doing this for a secondary gain (seeking attention, disability or financial compensation aka they are malingering) or these events are really not under their conscious control (usually these patients are under severe mental stress or may history of physical or sexual abuse). A trained eye (such as a neurologist) simply by looking at the clinical event shall at times be able to determine if it is a true seizure or a pseudoseizure/ hysterical convulsion. At times though the differentiation is indeed difficult (if solely based on the description of the event). A video-EEG in these cases is extremely helpful. As the name suggests the patient is attached to a EEG machine while under video surveillance. The idea is to capture a typical seizure on the camera and look at the EEG at the same time.

      3. If the patient suffers a single alcohol related seizure, no treatment may be necessary apart from simple observation and making sure the patient does not hurt himself. On the other hand if the patient suffers a flurry of seizures one after the other, you may have to give medications to stop the seizures at least acutely. Whether such patients warrant long term anticonvulsant therapy is another issue and needs careful consideration.

      4. Patients who are in DT or have impending DT usually have dysautonomia. They are frequently tachycardic or have irregular heart rate, their blood pressure may be high and have wide swings, they may have profuse sweating and are disoriented, confused and agitated (hence the word delirium). DT has a high mortality and hence these patients need close supervision and aggresive treatment usually in an intensive care setting.

      I hope I have answered your questions to your satisfaction.

      Personal Regards,

      Nitin Sethi, MD

  69. I had subdural hematoma 11/29/2009. Since then I’ve been on dilantin. Had my 1st and only seizure (knock on wood) July 15, 2010 at 5:00 p.m. My dilantin level had dropped to 6. I had 4 beers the night before. My EEG’s are mildly abnormal. My Dr. says keep taking meds, and abstain from alcohol.

    Pre-seizure, he said I could drink 1-2 safely. So stupidly, I have drank between 1 and 4 drinks on about 15 occasions in the last 6 months with no consequence. I’m probably just lucky, or can my body handle a few? Does it matter if it’s wine, beer, or liquor?

    I have an appt. soon, but any thoughts on the matter? I want to drink, but not willing to risk a seizure.

  70. I notice the vast majority of these posts involve alcohol. A friend of mine had a seizure in the middle of the night and had not been drinking. She was put on a medication that had really unpleasant side effects and being wary of pharmaceutical drugs decided to explore natural alternatives. According to some websites where people from all over the world report in, some people no longer have seizures if they take magnesium supplements. This worked for her so far. She has a friend on the drug she was prescribed who still has seizures. Can seizure problems ever be vitamin defiency related? As in perhaps alcohol depletes magnesium in the system and triggers the seizure? Some websites suggest that pharmaceutical companies mark up seizure drugs tremendously (which don’t always work) and so doctors are trained to encourage them instead of vitamins and minerals.

  71. My daughter is not a heavy drinker but does dring occasionally. last night she was drinking tequlia with friends and started having a seizure. from what i have learned it was a tonic seizure. She was at college and refused treatment when help was called. How serious is this and how likely is it to happen again. she is a student athlete and is in excellent health. Nothing like this has ever happened before.

  72. My husband averages between 7-9 bottles of beers a day. Last Thursday I heard a big bang on our deck at 11:30pm and knew he had fallen, when I check on him he had a gash above his eye. I took him to the hospital where he had 8 stitches. They did not check for concussion or anything else. The next day he got up at 12:20pm and seemed normal. He went outside and had a smoke, came back in and had some powerade (which he had drank on and off during the night too). Then all of a sudden he started collapsing. He fell three times in the hall. I did not see if he hit his head more but I did see him laying sprawled flat in the hall the last time. These three falls happened one after another within seconds as I was just in another room and didn’t take long to get to him. When I saw him sprawled I asked if he was okay he said “I don’t know”. He has NEVER done this when hung over. He then stumbled to the stairs and fell again on the stairs, hitting his head on a step. I asked if he was okay and he said “I don’t know”. I got the phone and asked if he wanted an ambulance. He said “I don’t know”. Then his arms started spazzing (big jerking movements) then his breathing got very laboured and his legs started jerking fast small movements. His eyes rolled in his head (I could see only white). I called 911. While on the phone he stopped and didn’t move, he didn’t answer me, I could barely hear him breathe. Then suddenly he got up and walked upstairs like nothing happened. When I checked him he was drenched (as if he just got out of the shower). The ambulance took him and later on I spoke to the doctor on duty who when I asked about head injuries she said “there’s nothing for us to look for, he had an alcohol seizure, he just needs to sober up”. I asked that since he had banged his head the night before could they do some tests and she said there was no need because the seizure is only due to the alcohol. I didn’t know what else to do or say so he got discharged and home we came. He was very sleepy the rest of the day. Slept all night, didn’t make a peep. The next morning at 10am he got up (Saturday now). He ate breakfast no problem. He wasn’t as talkative as normal but I just shrugged it off. Ate lunch no problem. At 4pm he started looking strange to me. Like wiped out and pale. He ate at 6. Then he started to vomit, started to sweat, could barely stand or walk. He kept falling asleep (maybe passing out?) when I tried to talk to him. I called the nurses hotline (we’re in ontario Canada) and they did an assessment and were shocked that no one ran any tests. So back to the hospital we went. He couldn’t even stand by the time we got there. A different doctor admitted him and he is there til Monday at least. My question I suppose…is was this truly an alcohol withdrawal seizure or was it from the head bump the night before? I know without seeing him it’s hard to answer, but our hospital is somewhat lacking in communication. Today (Sunday) I went to visit him and asked a nurse about what was going on to which I was told “talk to him, he’s capable of speaking” then she huffed and stormed off. Meanwhile I ask him what’s up and he is still falling asleep when I talk to him and is hard to understand sometimes (not normal for him) and doesn’t even remember if they took his blood (which I assume they did because he has a new swab on one arm). It’s frustrating. No one will communicate with me and I’m losing sleep with worry. My personal opinion is that they should have done due diligence and tested his head when he bumped it, or at least after the seizure (which that doctor also said “isn’t a real seizure”). I have no faith in my hospital but we live in the middle of nowhere with no other options. Thanks for reading my long winded “question”. Hopefully you can shed a bit of light even if it’s a guess.

  73. I have a friend who has bee an alcoholic for decades and never had a seizure. Just recently she has had 2 does this mean she is progressing?
    I think her blood work is normal, she gets it checked quite frequently she is a breast cancer survivor also. (So sad she can beat that just to die from alcohol) Just wondering she is still in denial after not being able to physically work for 7 years and a weight loss of 30lb. I know she is the only person who can deceide when to quit any info maybe that I can pass on about advanced alcoholism and seizures??

  74. I think I had my first siezire yesterday. I drank the night before(I usually Have 3to 4shots of vodka every night sometimes more to help with my chronic back pain.I am no longer taking percocets and Valium for the pain&spasms) I suffered a bad case of MRSA& had to have surgery on my leg(I was in the hospital for about 8months& the entire time I was given daily demoril doses through my iv.) Before I was discharged they gave me my last dose of demoril ans sent me on my way with bottles&bottles of pain meds, they never said anything to me or let me know I might be or could be addicted to pain meds. So at the age 18 til 23(now) im in chronic back pain..so bad I can’t stand to long,lay down to long,sit up to long, therapy, injection,pills&& alcohol … I absolutely lost and have not been able to find a doctor that has truly helped me. Pls tell me sominthing I can do.

  75. I’m writing to you from South Africa, as I can not get a good lead of who to contact to help me in South Africa.

    It seems that doctors don’t think my son’s problems has anything to do with the fact that he had Encephalitis as a baby.

    He had the illness when he was 5-months old. For years to come he would hallucinate when contrcting the slightest fever.

    He is now 25 years old, very healthy otherwise, weighs in at 97kgs of muscle. He is very active in the gym and in sport.He had a hectic Rugby career with some major head injuries as well, which could have contributed to his condition at present. He is a highly qualified Chef. Attached is a picture of him for you to see that he is in good health.

    Unfortunately he is quite a “Party Animal” and has recently started getting convulsions after a “heavy night out”. This has happened 3 times in the past 8 months. During the period he has also experienced memory loss whilst at work, feeling he was going to pass out, and not quite knowing where he is. He admitted that it felt like memory loss.

    He has memory problems, he has personality changes especially when he’d have a few drinks, he is quite angry at times, he had attention difficulties as a child, but besides that, did very well at school, he does talk to himself quite a bit, but that might stem from his childhood – he always had imaginary friends. I think they might still be with him? It was very cute though.

    We’ve had MRI scans and all sorts of things done, which shows up nothing wrong. I just feel totally helpless, as doctors just say that he will be fine, nothing is wrong, but I can’t just accept it.

    Do you think that this condition could be from his illness as a baby or can you steer me in a different direction. I feel quite desperate at present.

  76. Hi, I am writing because a little over 5 years ago I decided to try to get a handle on my abuse of alcohol and quit drinking suddenly. At the time I did not realize how dangerous this was and ended up in the ER due to have a 3 minute seizure. At the time they put me on dilantin. I have been alcohol free for the last 5 years and also seizure free. I am in the process through my neurologists instructions to gradually come off of it. I have had 3 EEG’s since the episode all of which came up normal. Even the one immediately following the seizure itself. My mother does suffer from epilepsy but I have never been told I have that nor have reason to believe I do. My question is, how likely is it that I will ever have a seizure again? I suffer from anxiety/panic disorder so I find myself somewhat obsessing about the possibilty of it happening. What are the chances a seizure could happen again? Are there any warning signs prior to a seizure? I would like to be able to come off of this drug without worry. I started taking 100mg of Dilantin 3 times daily. In the last year I am down to 100mg once daily. In the past two weeks I am down to 100mg every other day with the intention of coming off of it completely in 1 month. My Dr was pretty careful in saying that they can occur at anytime but it is unlikely in my case. Do you have any statistics in regards to reoccurance alcohol related seizures years after alcohol has been present. Thank you for your help and thank you for having this as an avenue to go to.

    Kelley

  77. Hello,
    I have a very close friend of mine who is assumed to have a type of alcohol. induced seizures.. He has had them every 6 months and it just happens to happen after a night of drinking beer with friends. What confuses me is that before the 6 month mark of his last seizure he was celebrating a friends birthday and drank hard quite a bit of hard alcohol and nothing happened… But 2 weeks later he had about 8 cans of beer and the very next morning had a grand mal seizure. Can you determine if you think this truly is alcohol induced are a form of epilepsy… I hope to hear back I am very worried about him.

  78. I was curious, I’m a 21 year old college student.
    I was on the drug Topomax for awhile to control migraines (turns out eliminating certain foods from my diet solved the problem for the most part), but I was also binge drinking (no worries I no longer do). Whether or not I was an alcoholic is up in the air (I currently do drink, but never to get drunk- always socially) but I have had a few people tell me they witnessed me having seizures while drunk. One used the word seizure, while another told me I looked possessed (poor girl).
    Was this possibly due to the combination of alcohol and topomax? Also, what long-term effects could result from this? I’m mostly worried about that. As I no longer live that lifestyle I have not had any more seizures.

  79. I found this very interesting my partner is 31 he drinks a litre of vodka sometimes more a day he has been drinking for years & has been admitted into hospital 3 times over the years for liver failure & has been told he has the beginnings of scorocis of the liver yet despite everything he still went back to the drink after a couple of months each of abstaining from it, my point is he’s now fitting has sudden shooting pains in his rib & stomach areas his legs are painfully stiff where he can barely walk & they are swollen too he can also feel his liver swelling & has pain, he also vomits every morning & through the day sometimes there’s blood in it but he won’t seek medical attention despite my pleading I’m concerned the end is near & don’t want to find him dead but have almost give up as I know with every drink he has he’s dying, any advice? Are these fits his bodys last warnings?

  80. My son is what he calls a moderate drinker. He doesn’t consider himself an alcoholic because he only drinks beer and he doesn’t drink everyday. The problem is I think when he drinks it’s excessive and if he’s not considered an alcoholic I think he’s definitely borderline. Anyway, about 3 (sometimes 4) nights a week he drinks 2-40 oz beers (sometimes 3). When he drinks 2 it’s not so bad, but when he drinks 3 there are times that he looks like he’s in a dazed stupor. It’s kind of like he’s passed out except that is eyes are open. He just stares, no talking, no blinking, he can’t hear me and sometimes hyperventilates and acts like he’s having a hard time breathing. Most of the time he comes out of it on his own but sometimes I have to bring him out if it by spraying water in his face or slapping him. Of course I tell him later about what happened but unfortunately he doesn’t remember; so I feel like he thinks I’m exaggerating or making it all up to get him to quit drinking (his father is an alcoholic). The problem is the other night it got worse than it had ever been. He drank 3-40 oz beers in a period of 5 hours and started having trouble breathing… he then slid to the floor and started convulsing. He was thrashing all over the floor, his eyes were rolled back, he acted like he was having trouble breathing and was hyperventilating in addition to gagging like he was choking. I checked to make sure he wasn’t swallowing his tongue or that his throat wasn’t swollen for some reason and called 911. A few seconds after they told me to roll him over to his side the seizure finally stopped; it lasted approximately 1 to 1-1/2 minutes. Unfortunately my son was attacked twice over the past 2 years and had 2 head injuries as a result of the attacks; one of which required staples. The cat scans at the time of the injuries didn’t show any serious damage but my concern is that something else may have occurred over the past 6 months as that is about when the problems started. I’m not sure if the dazed stupors and breathing problems along with the seizure that he just had is totally due to the beers, but I do feel that the alcohol could be inducing another deeper problem that hasn’t been found yet. Anyone with advice that has any similar experiences with this situation would be greatly appreciated.

  81. Hi there, I don’t drink very often, maybe a glass of wine a couple of nights a week and the odd night out with friends. However, last night I went out and drank much more than I usually would. Obviously I had a hangover today but at one point when I was starting to feel better I suddenly started to sweat terribly and felt very nauseous. On the way to the toilet to be sick the world went black and when I woke I was on the floor but had no control over my body. My whole body was in some kind of spasm and i had no idea where i was or what was going on. I don’t think this lasted for more than a minute. Is this what people refer to as rum fits’? I was unsure as it occured so long after i stopped drinking. Should i make a doctor’s appointment? Help would be appreciated as the whole experience was rather frightening. Thankyou.

  82. Dear Doctor ,

    I am 24 years of age and started drinking socially weekends only, back in high school.
    I started working and traveling abroad and found it fun and exciting exploring new york night life with my new friends, mostly weekends/ days off, some times binge drinking as well. I think I quickly developed a tolerance to alcohol since I could easily out drink my friends. When I moved home to Scotland and started working in a very popular bar in a holiday town, nights out increased drastically. I shared a flat with a person very keen on having parties so even after finishing work there will be drinking involved. 5-6 units a day most days. Didn’t find it odd as every person I knew was doing it, drinking at night turned into a ‘hair of the dog’ in the morning when the hangover was too much. This went on for 3 years ‘seemingly’ fine as I had a steady 6days a week job, gym every day and felt relatively healthy. I found on nights I didn’t drink it was nearly impossible to get to sleep, especially working different shifts each day. Eventually I got fired after not showing up to work since we had a bender of a weekend I can barely remember. Drinking didn’t stop – in fact with all the free time it got worse. I am now absolutely over feeling like crap all the time and having a reduced quality of life. I mentioned to a friend that I wanted to quit and he warned me not to quit cold turkey because of these withdrawal symptoms. I have also quit smoking with no outside help and believe that my motivation with quitting drinking will get me through. I’ve cut down drinking to 4units a day. Would it work if on a weekly basis I lower it down one unit, and after a month have one unit every 2nd day. And also is this a safe method or should I rather take valium? I’ve seen it has a lot of side effects and also causes withdrawal symptoms after an extended period and it also has a long list of possible side effects which I find discerning?

    Thank you in advance with regards to this matter.

  83. I am 28 years old and am relatively healthy. I drink on average 2 units per day and would say I get drunk once a week. (writing this I already realize I drink too much!) After having a couple of drinks, Id say at least 3 glasses of wine I have what I refer to as ‘jits’ the following morning. My ‘jits’ are short sharp fits where for a split second my body convulses, I loose thought and have fallen to the floor with one in the past. I know when they are coming on as my head feels like mush, I can almost feel it in my brain. The jits will last all morning and get less frequent as the day goes on, by about 3pm I am normally clear of them.

    I have been having these jits the morning after alcohol for as long as I have been drinking… Being woken too quickly or not enough sleep will also cause them. These fits vary in that some times a lot of alcohol the night before causes mild jits the following day and other times a glass or 2 will make them more server and constant.

    I have been to the Doctors about the issue in the past and have been told by one, it is petit mal epilepsy and another that excess of any substance will cause any human being to fit. Like I said, it is not always drinking excessively that causes them.

    It is almost as if I my body goes into withdrawal overnight… I have in the past had alcohol in the morning the morning to stop them, weather this has helped or wether they have just passed Im not certain.

    Could I have an allergy to alcohol? Could my body be more susceptible to it than others? Could it be something to do with blood sugar level dropping and not alcohol at all?

    Reading through your comments and advice above, I dont see any other post that is similar to mine in that the fits are very short and quick.

    Thank you in advance.

  84. Dear Tyler,
    thank you for writing in. I am afraid the answer to your questions is not so simple. Whether your convulsions/seizures are alcohol related or whether you have an underlying seizure disorder (epilepsy) and excessive alcohol intake “brings on”/ precipitates the seizures needs to be determined. Usually your physician shall order an EEG study and a imaging study of your brain (MRI or CT scan). Based on that he/she shall be able to prognosticate you further. Like for example do you warrant to be on anticonvulsant therapy or whether simply stopping alcohol consumption shall be sufficient.

    Personal Regards,
    Nitin Sethi, MD

  85. Hello,

    First of all I really appreciate this article being created here it’s quite helpful.

    In concerns to my own situation about a month and a half ago, during Canadian Thanksgiving, I went home with the gf to see the parents. I believe I had drank the night before but am uncertain. My parents and brother were quite concerned about me as I looked very unhealthy, was sweating profusely and just looked kinda gross over all. The next day I went home and went out to dinner with the gf. Upon walking home I could not focus my vision and I felt very unwell, then my memory blanks and I woke up in an ambulance on the way to a hospital, they treated me for a seizure.

    While this was quite the worrissome, I dismissed it as a fluke situation. I went and saw the neurologist and have gotten the heart rate test and eeg, although I do not yet know the results. I am going there tomorrow.

    Unfortunately on Sunday I was again out for lunch with my girlfriend and upon the walk home, in the same park no less, I had another seizure. I have no memory of it occuring, I just wake up in the ambulannce really disoriented to my girlfriend crying and being looked after my the ambulance workers.

    I am 23 years old, and I drank quite excessively with my friends throughout university and during the year and a half after graduation. I had binge drank the night before, smoked weed and 2 cigarettes. I don’t ever feel symptoms of withdrawal from booze and I hadn’t really drank after thanksgiving before this time. But I did drink the week before and while out for breakfast that morning I had feelings of going to seizure in the restaurant. I had also drank the night before. Other than that I am quite healthy, I work out quite steadily but now am terrified to drink or anything else. I am currently on dilantin as the doctor at the hospital prescribed, but it makes me feel funny and I sincerely hope I can get off it. I’ve drank heavily for maybe 6 years now, probably less. I smoke quite a bit of weed, sometimes heavily sometimes not so much and I have picked up the nicotine habit, although I am trying to quit it.

    Do you have any advice as to my possible condition? Am I doomed to be the sober kid at the party for the rest of my life? Any direction would be greatly appreciated

    • Dear Ian,
      thank you for writing in to me and I am glad you found the article useful. Ok now to answer your questions and I shall give you the practical points:

      –from history it seems you suffered two convulsions. Important questions to be answered: were both witnessed convulsions by your girlfriend–did she see you convulsing? Or did you simply pass out? Did you bite your tongue or wet your pants during the above two episodes?

      –both the events occurred in close proximity to each other so more than likely the same causative factor/ factors are implicated.

      –can we attribute both the events/convulsions to alcohol overuse/ sudden cessation of alcohol and the intake of marijuana or do you have underlying epilepsy? (meaning a condition which predisposes you to multiple unprovoked seizures in your lifetime)

      The results of tests such as EEG, neuroimaging such as MRI, EKG, holter (if needed) shall help to answer the above all important question. Tied to that answer is the answer whether you shall need to remain on an anticonvulsant (such as Dilantin) and if yes for how long.

      The answer to you last question is easy. No matter what the tests show, you should seriously consider abstaining from alcohol completely. If that is not possible, you should drink in extreme moderation.

      Follow up with your doctor Ian and feel free to write in again. I apologize for the delay in reply.

      Nitin Sethi, MD

  86. Please help. My brother is having an alcohol induced episode right now. He has been getting these for 3 years (to my knowledge) the day after drinking heavily (also one time after he had severe stomach pains/vomiting). He complains of chest pains, is confused, says he doesn’t recognise things, can’t pick up a cup to drink, tried to leave the house without shoes & thought he’d missed Christmas. He ‘spasmed’, by which I mean his arms and legs were twitching and his teeth ground together. This lasted a few minutes on and off. He struggles to find words/express himself. He’s frightened and very depressed. This has been going on for a couple fo hours now.

    • Dear Lauren,
      at this point the best you can do is to gently restrain him. If he is having a seizure, turn him to one side and place a pillow under his head. Do not put anything into his mouth if he is clenching his teeth. All you really have to do is make sure that he does not injure himself during the convulsion. Have someone call the emergency health services and take your brother to the nearest hospital for further evaluation and treatment. My very best to you and him.

      Nitin Sethi, MD

  87. Hi
    I’m 15 and I’m healthy, i’m not a heavy drinker or anything, ( i only probably drink 1 to 2 times a month at house parties and birthdays)

    However on Friday after drinking in excess i had several “fits”. I do not remember these episodes but my friends told me that they lasted for roughly 2 minutes at a time, and then between each seizure i was dazed and confused and look like “there was no one there”.
    I have drank the same amount before and this has never happened.

    Due to my age, i don’t want to talk to my parents or doctor, so i was just looking for some advice and whether there is any need to be concerned.

    thanks :)

    • Dear Liz,
      Thank you for writing in to me. While based on your history I cannot say for certain whether you suffered convulsions and what role alcohol played in all this, I do have a few words of advice. You should consult a doctor. Your parents are likely going to be angry and upset when you tell them what happened. That said like any parents they love you and after their initial anger is over, they shall help you and take you to see a good doctor. Keep me posted and let me know what the doctor said.
      Nitin Sethi,MD

  88. Dear Nicole,
    let me answer your question in this way: you suffered some kind of event (maybe a seizure) in the setting of heavy alcohol use. Yes I think you should be concerned enough to have this checked out. Mention it to your primary care physician and you can start from there. In the meantime do not drink till the evaluation is complete.

    Nitin Sethi, MD

  89. Hi,

    Last night I was drinking with a friend at his cabin. I had 4 shots of rum and 6 beers (regular, 4%). When I woke up in the morning I tried to drink tea and water, and threw it both up. I made my way home feeling very sick and dizzy and went with my father and brother out of town. On the trip I must have passed out, because I cannot remember anything from then to the time I came home. They rushed me home, I was apparently having a seizure for about 1 minute. Do I need to be concerned about this? My parents would like me to go to the hospital, but I’m afraid I’ll lose my license.

    Mike

  90. Dear Nitin,
    My partner is an alcoholic, consuming a bottle of vodka every day, plus with cigarettes spending about $700 a week on his habit. He has not worked for 6 months, was existing on his own money but it has now all been spent. He becomes verbally agressive and threatening if he is deprived and recently had a seizure due to not having alcohol for 24 hours and in hospital Xmas eve.
    I refuse to be intimidated into giving him money, as I have said to him previously that as I was not allowed to discuss his smoking and drinking, that when he did become ill I would not support him.

    He has an appointment mid February for counselling for alcohol addiction, however my concern is to survive until then. Do I call the police only for them to take him away and then send him back? I feel humiliated by his behaviour and would feel better having some advice.

    • Dear Pam,
      thank you for writing in to me. I am sorry to hear about the tough issues facing you and your partner. Alcoholism is indeed a very serious problem and alcohol addiction is indeed tough to treat. A few words of advice. You partner needs professional help and at times it is very hard to convince the alcoholic patient that he needs to see someone as soon as possible. They frequently become resentful and angry. Try to enlist the help of family and friends whom he trusts and is comfortable with. In our hospital we have social workers who are a big asset. A social worker shall be able to give you a lot of information about organizations such as AA and other alcohol de-addiction programs in your vicinity.

      My best wishes to you.

      Personal Regards,

      Nitin Sethi, MD

  91. What I have been going around trying to find what happens now if I ever drink again? From what I understand even a small amount can trigger seizures after having withdrawal seizures or a small amount can trigger them again. 12 hours or so after I stopped drinking I finally got to sleep and was awoken all night by partial onset seizures. It’s pretty frightening and I’m hoping it will finally help me never drink again. I did find that at least I’m not epileptic but what if I continue drink. Will become epileptic. To be honest I don’t know why I’m asking because I know I never should drink again. I guess I’m just hoping the answer is as bad as I think it is..

  92. i am 29 years old and started having tonic clonic seizures from when i was in my 2nd year of campus to date. i have been from doc 2 doc but i have never really gotten a solid answer or treatment for that matter, concerning the source and cause of my seizure attacks. i am currently on 300mg epanutin and 200mg carbamezapine daily medication and still get an attack once a month. what would be a more direct resolution to my condition; now that i have cut down on my alcohol intake 2 about 1ce or x2 a month? is there a better prescription?
    thank u

  93. Hi Doctor Sethi,

    I want to applaud you for keeping up this blog. Because I found your information so helpful, I encouraged my girlfriend, who is a neuropsychologist, to consider maintaining a similar blog in regards to her practice and research interests.

    I had my first seizure (~1.5 minute grand mal during awakening around 6 am) two weeks ago at the age of 28. I am questioning how much I should characterize it as idiopathic or provoked by alcohol withdrawal.

    To give you and the readers background, I was a functional alcoholic for over ten years until I decided to quit “cold turkey” this past June. Years ago, I attended Alcoholics Anonymous, drank heavily and often and experienced many unnecessary challenges in my otherwise successful and happy life. The decision to quit and success in staying sober was due to a strong follow-through.

    I didn’t drink at all for seven months until I decided that I may be able to “drink like a normal person” instead of not at all. So two weeks prior to my seizure, I had four drinks at New Years Eve.

    Three days before my seizure, I got very drunk for the first time since June. The night of my seizure, I had a few drinks.

    I awoke from the postitical sleep quickly. CT scan, EEG, blood and urine work, vitals and other diagnostics showed nothing suspiscious. I told the MD that in addition to trying to fix my alcoholism, I also take an excessive amount of caffeine daily (~1000 mg) and/or a lot of fitness supplements including creatine, beta alanine and amino acids. Complicating matters, I had also quit smoking in June too.

    Before that I had cut back for many years and was a full time smoker before that for several years. Since June, I had regressed sometimes and smoked some but rarely and mostly I wasn’t smoking with or without a nicotine patch.

    Clearly I was making a very strong effort to change my bad habits. As part of that, the fitness supplements were used as part of a very rigorous regimen that included running 3 to 12 miles AND weightlifting vigorously for over an hour per day and 4-6 days per week. I also played highly competitive men’s basketball often.

    I am sure that contributed to my overconfidence and decision to drink again :)

    The MD suspected that the seizure was probably provoked by this wild combination of alcohol withdrawal, the supplements, extreme fitness, nicotine withdrawal and/or caffeine overload.

    In addition to those habits, I probably enhanced my idiopathic seizure tendency through a history of illicit drug abuse including ~10 years of habitual marijuana and some brief (several months) experimentation with cocaine, psychedelic mushrooms and percocet painkillers many years ago.

    With this picture of me in mind, I believe that my seizure is better characterized as provoked by alcohol withdrawal, etc., than unprovoked. Do you agree?

    I want to know because the recurrence risk is much lower for seizures provoked by alcohol withdrawal than unprovoked.

    Furthermore, I can cite several studies that show brief, solitary, awakening grand mal seizures like mine (~1.5 minutes) are much less likely to recur than first seizures that last longer (typically 10 minutes or so). Non-recurring cases tend to have briefer first seizures.

    Also, if you have suggestions for dietary, lifestyle and substance changes that I can make to maximize my seizure threshold and avoid a recurrence (and the epilepsy diagnosis) I would appreciate hearing them very much.

    Thank you Doctor Sethi.

  94. Dear Nithin,

    I suffered my first seizure in late August of 2011 and recently experienced my second one this past Sunday. During both instances, the seizures occurred within 8 to 10 hours of my last drink from the night before. I can only assume that these are alcoholic withdrawal related. I do not consider myself to be an alcoholic as I only consume generally on Fridays and Saturdays. I tend to consume between 8 to 12 ounces of single malt scotch (neat) over the weekend.

    I also do not lead a sedentary lifetime as I work out / condition 4 times a week and also stick to a weekly diet that consists of mainly protein, vegetables, raw nuts, and berries. My carbs, desserts, and fried foods are generally consumed on the weekends.

    My family does not have a history of seizures or epilepsy. After my first seizure, I had taken an EEG as of last October 2011 which revealed nothing out of the ordinary. Currently, I am being scheduled for an MRI, ECHO and Cardiogram tests which will be occurring over the next two weeks.

    I would be grateful if you could provide your comments and / or thoughts on the following:

    1. Because I have now suffered a second seizure, is it safe to consume 2 to 4 alcoholic drinks per week or should I consider giving up alcohol completely?

    2.If it is safe to consume a small amount of alcohol on a go forward basis, would it be best to “detox” for an extended period of time before electing to have another alcoholic beverage seeing that its been a week since the second seizure occurred?

    3.If my EEG, MRI, ECHO, and Cardiogram come back normal, is there something else I should consider doing?
    Many thanks for your comments, thoughts and / or advise.

    Regards,
    A.K.

  95. Dear Dr. Sethi,

    I am a 23 year old college student. Back in 2006 I had my first seizure episode. I was up for most of the time the night before playing video games and I got about 4 hours of sleep. I would like to note that when I play video games I tend to focus/concentrate pretty hard. The following morning I was accompanying my parents out and we went to an extremely crowded store in India and it was really hot. The moment we came outside the Madras heat got to me and I started getting sort of a nervous feeling and felt really uncomfortable. I patted my dad on the shoulder at which point I fainted and started seizing. I was admitted to a local hospital where I gained consciousness rather quickly. I only had an IV drip and don’t think they gave me any other drugs. The following morning we visited a neurologist and after examining me and performing an EEG he said it was an isolated incident and the chance of a second seizure occurring in the next 5 years was 30%. A little bit of history – I was 17 back in 2006 and I had tried alcohol 2-3 times and only once did I actually drink enough to get drunk. I also had smoked cigarettes a handful of times by then.

    Fast forward to 2009. My 4th year of college. By that point I’d consumed a significant amount of alcohol, although I wouldn’t categorize myself as an alcoholic. I drank on the weekend while out with friends, but never in the morning or while I was by myself. Every time I drank I limited myself to around 5-7 mixed drinks. Also, I used to smoke a lot of pot. It became a habit to smoke a little at night after a long day of classes and studying. I had also tried E once. So in 2009 in the middle of a hectic week I decided to take some adderall to help me get through several tests and papers. I took about 80mg of adderall over the course of 48 hours with minimal sleep (2hours) and didn’t eat much either because adderall tends to kill my appetite. On the third day after finishing all my tests and presentations I decided to unwind at around 2pm. I hadn’t had anything to eat since the evening before. I came back to my apartment, but I was having trouble sleeping because of the after effects of adderall. So I went to hang out with a friend for a bit. We decided to smoke a little pot as I thought it would help me relax. After smoking I was relaxed and fine. We started playing a video game and when I play I really get into it. I started feeling a little uncomfortable and got a nervous feeling about 20 minutes into playing. Immediately I fell of my chair and started seizing for about 15-20 seconds. I regained consciousness immediately and decided to go back to my room at sleep it off. My friend insisted that he call the ambulance and so I let him. I got to the hospital and I must note I was feeling fine the entire time. The doctor took a history and I told him about my incident back in 06. The took a MRI and CAT scan to be sure and the attending told me that it was an isolated incident and there was nothing serious that showed up on the images. After that I went home feeling completely normal and slept. I had pulled several all nighters using adderall before this incident and never felt anything remotely close to a seizure.

    I also recently remembered an incident that I had when I was really young – around 13 years old. I was at the arcade with a friend and we were intensely playing video games for about 2 hours. At a certain point I started getting a nervous feeling where my eyes felt extremely strained so I left the video game and looked away and closed my eyes. I got something to drink and relaxed for a bit and after that I was fine. I was scared as I was young, but afterwards I didn’t make much of it so I didn’t bother telling my parents. A couple of days back I found out that my uncle (mom’s brother) had a seizure episode back in 2005 and was put on medication after only a single episode. He was put on ValprolCR, Unicobal TNJ&Forte, Ativan 1mg, Gluconorm and PimOmH40. He has been taking these medicines ever since. He is also a diabetic. The doctor advised him not to consume any alcohol while taking these medicines. He used to be a regular smoker and drink regularly and was drinking against his doctors advice while on the medication. Recently his condition took a turn for the worse and he has become extremely weak presenting with loss of memory, consciousness even while awake and uncontrollable minor shaking in one of his arms. I also recently learned that his son (my cousin) had a single episode back in 2004 and was put on medication for about 3 years and he hasn’t had anymore episodes since. In addition, my mom’s grandfather also supposedly had an episode (not sure how many). I understand that epilepsy has a genetic component to it and I’m worried that I might have it/be prone to it even though I was not diagnosed with it. My career goals are heavily involved in academia and I’m worried that this might limit me in certain ways. Not to mention prevent me from doing daily activities such as driving. What are the chances that I will be diagnosed with epilepsy and/or have episodes in the future? Is there a strong likelihood that I will pass this on to my kids? Also, should I completely avoid alcohol even though none of my episodes occurred while/after consuming alcohol? Your blog has been extremely informative and I appreciate you taking the time to read my case.

    Best regards,

  96. hello! i suffered a seizure the morning after drinking about a year ago and had my license suspended. I didn’t think much of it and continued to drink occasionally until it happened again a few weeks ago. The doctor diagnosed me with epilepsy but i do not think that is a fair diagnosis. I went through a 48 hour EEG and an MRI and everything came out completely normal. Can two seizures from alcohol be considered epilepsy? I have never had a seizure in a non alcohol related situation. Thank you

  97. Thanks doctor, I have been searching for this answer. I have had 2 episodes of tonic-clonic seizures after a gap of 5 years. Both were after a binge drinking nights and late sleep. Sleep deprivation. Does this mean I am an epileptic? Also if I have drinks in moderation will it lead to a seizure again?

    Thanks

  98. My husband who is 33 does have an alcohol problem but recently when he has been drinking a lot has these episodes where he like goes into some kind of trance and the left side of his body tenses up . These episodes last for about 3-5 min I’m really really concered afterwards he doesn’t remember and he thinks I’m making it up . Does anyone know what is happening

  99. My husband has had seizures on 4 occasions, first when he was 19 when he was playing soccer in college 5 days a week and got the stomach flu and had diarhhea and vomiting, he then had a seizure. Then again when he was 22 after a night of heavy drinking which he rarely does he got sick vomited and diarhhea again, then had a seizure in the shower. Then on his 26th bday last march, heavy drinking again, the most I’ve ever seen him drink. That night he again vomited, diarhhea and had multiple seizures and had to go to the er cause he fell in the bathroom, after 2 bags of iv fluids he was fine, of course he had a hangover. The most recent one was 2 weeks ago, I had the stomach flu 2 days before then we were drinking wine he had 3 glasses then went upstairs and collapsed on the bed and had a seizure. After the seizure his stomach was upset and he had caught the stomach bug I had. My question is can dehydration cause seizures as well ? Cause the first time he had them he was not drinking but was dehdrated from the stomach flu. Also he says he can feel them coming which is a good thing cause he went to lay on our bed this last time. They are so scary but I know this is something we are gonna have to deal with and manage. He had drank mutiple times in between these episodes, it just when he drinks on excess of has a flu or something he gets them. He went to a neuroligist last year and she said alcohol cannot cause seizures and just wanted to prescribe him meds, which I do not agree with because they happen so rarely. Thanks for this informative article =)

  100. nearly 4 years ago I was rushed to hospital after having 2 tonic clonic seizures,I had been heavily drinking the night before & was out in the sun the day after,so I think dehydration & the fact I can’t drink when I have been drinking :(,I had an MRI brain scan & ecg & was found to have an epidermoid brain tumor at the inside of my cerebellum (coincidental finding) & has nowt to do with my seizures!2 years later after a week long party holiday I had another tonic clonic on the plane,then 2 in the hospital…again put down to my lifestyle!then for 9 months nothing but the past 8 months I have been having days with seizure like activity…I’m totally alert when it’s happening,a little bit like one but of my brain is dreaming but the rest of my brain is still normal going oh here we go again!!this usually happens after a night on the tiles with my friends,but not after every night which confuses me!!my sleep pattern is terrible & worrying usually makes it worse!!i’m due new brain scans etc to check my epidermoid & see if anything can be done to help me,in the mean time tho I am staying off heavy drinking & red bull is the devils juice I’m sure of it xx

  101. HI, I was 21 when I had a seizure, following a weekend long music festival and drinking heavily and consuming amphetamines. Had about 5 or 6 following this up to the age of 25, mostly following drinking heavily and sometimes consuming amphetamines and/or diazepam. Have not taken any illegal substances since and now in my 30′s. Still drink regularly. No seizures and spent a few years taking a very low dose-100/200mg of epilim chrono(sodium valporate). Have not taken medication for 4 yrs approx. A junior doctor told me(while the consultant had left the room to fetch something) that he had studied this for his theses and it was very common for young adult males to “develop” seizures but assured me I would grow out of it, which appears so far(touch wood) to be true. Is there any truth in this? Is my case prob related to drink/illegal substance misuse?

  102. I wanted to address another way alcohol can effect seizures. I have had Epilepsy for 30 years. I was diagnosed when I was 15 and had my first grad mal. Here is the story. On Friday night I went to a school dance. I drank my first ever glass of wine. Was fine for 2 days. Then on Monday morning I had my first grand mal seizure. I have had Epilepsy ever since. I can tell you with all certainty that all it takes is a sip and within 48 hours I will have a grand mal. I also have seizures that occur even tho I do not drink. They fall around my period but I have trouble getting a neurologist to take the timing serious illness even after having brain surgery and a VNS and still having seizures.

  103. hi i am ay 20 year old i have had 5 seizures the first 3 was like 6 months apart but the last 2 have bein within the last month, all 5 fits have occured after a night out not so much a heavy night drinking just my usuall social drink with friends, i have bein to the hospital each time after a fit and the doctors have all told me different things some say i have a mild form of epelepsy others say i dont and i need to not drink ever even one or two, im just really confused and feel like the doctors are just guessing my dissorder rather than a full diagnosis, i am on a waiting list to see a neuroligist, in the mean time i have quit drinking because i dont want to put my family and girlfriend through the worry, could just do with some advice or anything with someone with a simmular story, many thanks jamie

  104. Hi,

    (PLEASE REPLY)

    I am a 20 year old student from India.The first time I had a fit was when I was almost 16.I had been using Coke(about 1g per day) regularly for 2 months.I was sleep deprived as you dont fall asleep too easy when on C.So once I was doing the s*** whole night,slept for 1 hr and was getting ready for school.As i had milk I collapsed with my eyes goin here and there and some stuff maybe saliva coming out of my mouth.I was taken to the hosp.,my scans were all normal and after a week i was discharged.The second time I had a fit was when i was 18.That happened while i was giving an exam in the college.I had’nt slept well for about 3-4 days. During the fit my eyeballs went up and down,mouth remained opened with some stuff maybe saliva coming out(as i was told by friends).That day I got my MRI done.Evtin was normal.I would like to tell you that I had used Coke 3-4 times since the fit within a gap of 13-14 days(I had not done it before i.e. after my first fit) and was quite a drinker (atleast half a bottle of rum) after the age of 17,though I had’nt consumed alcohol or Coke since the past week I had a fit. Now, after about 1.5 years i.e. at the age of 20, I was sleep deprived and had been taking alcohol atleast once in 2 days (gave up coke at the age of 18) , I was studying at home for the whole night and around 8 a.m.(i hadnt slept) I experienced another fit. I was taken to the emergency and given some injections. I got admitted for 2 days. My EEG,MRI was normal. The doc said I had some kind of epilepsy and gave me 2 medicines (Levipil 500 and Zyrolic) for 2 months.Its been about 1.5 months since I had the fit.I have started consuming alcohol(atleast half a bottle of rum) every second day and smoke cigs daily(been about 4 years).Whenever i am going to drink I skip my dose and the next morning I take the medicine. I would like to ask you is this consumption alright? or do i need to reduce this ? or should i completely stop it?(which i wouldnt like) and Is this epilepsy because of alcohol,lack of sleep,stress or any other reason? and can having sex or masturbation worsen my condition? . Lastly, i would like you to know that I have been a sportsman throughout and have a healthy structure.My diet and evtin is pretty healthy.

    Thanks,
    AB

  105. I have lived with my mom my whole life with her being addicted to alcohol. She has been a regular alcohol user for a loooong time now. Well last year she got two dwi’s, and she had to quit drinking. She did good until a little before summer of 2011. Now, May 2012, everytime she gets drunk, every day…., she starts having these “fits”. I don’t know exactly what they are, but she has really bad chest pains all the time, and they only get worse when she drinks. She’ll start grabbing her chest and take reallly short breaths, and then her eyes start to go up, she starts choking(I have no idea on what), her arms and legs start jerking and moving, but she’s like unconcious while she’s doing it, and when she finally starts to come to, she spits out(not that I wanted to know the details on this, but she got it all over me when I tried to help) really thick white-ish clearish mucous stuff all over. She absolutely refuses to go to the hospital because she’s afraid of what they’ll tell her, and she doesn’t want to pay a doctor’s bill, even though her health is more important. It doesn’t help to call 911 either, by the time they get here, she’s already recovered from the “fit” and tells them to leave. I have no idea what to do, and I don’t know what’s wrong with her…help??!!

    • Dear Sidney,
      thank you for writing in. I am afraid I cannot and should not attempt to diagnose her over the Internet. I share your concerns though and agree that she needs to be evaluated by a doctor as soon as possible.

      Personal Regards,

      Nitin K Sethi, MD

  106. Dear Dr. Sethi, thank you for this site – I pray that the folks who write in will take your suggestions and do whatever it takes to abstain from alcohol. My 31-year-old son died on April 7, 2012 of a blunt head trauma caused by a fall prompted by a seizure. He had been having seizures on and off over the last 8 to 10 years and was on Dilantan, prescribed by his neurologist. He was sober for about three years, on medication, with no seizures and then one day decided he would have a drink. That was the beginning of the last three years of his life. He was in such a vicious cycle – he wanted to stop drinking once and for all, but he feared the withdrawal symptoms would bring on a seizure so he justified that next drink. I know now that the complaints he expressed the last couple of weeks of his life were from trying to detox himself, but the symptoms were just too frightening and the only answer (in his mind) was another drink. The neurosurgeons said aside from the extensive damage to the left side of his brain, where he fell, his entire brain was bruised, contused and bleeding which perhaps accounts for his behavior those last weeks (sleep walking, not sleeping, hallucinations, violent responses to simple situations, confusion, headaches). I was glad to read your comments about taking the time to properly diagnose alcoholics and especially to follow up with getting needed treatment. There were times my son was in the ER and was told they “didn’t treat alcoholics,” when the symptoms he was experiencing was much more than just being drunk and I told them so. It is a heartbreaking thing to lose a child, adult or not, and to lose them when it could have been helped is even worse. Of course, he was an adult and responsible for his own actions – not to mention coming from generations of alcoholics on both mine and his father’s sides but it doesn’t change the fact that he is gone before his time. Alcohol is a killer, a celebrated, protected, revered, LEGAL killer.

    • Dear Nana,
      thank you for sharing your son’s history with me. I am sorry for your lost. Stay strong Nana. I hope your words will help someone else in need.

      Personal Regards,

      Nitin K Sethi, MD

  107. Dear Dr. Nitin
    How are you doing ? Well I came across your blog while surfing google regarding epilepsy issues. I don’t know if I am an epileptic sufferer or with seizure. either 30th may or 1st june 2012, while I was working over the computer in my room, suddenly I felt that my eyes started seeing everything being gloomy and my neck started turning to the right hand side while trembling very faster which I could not control and fell down on earth. And after that my dad came near to me and set and asked what happened I told him every thing and the same day or constant two three days at large it might have happened 3-4 times and then I started forgetting everything then he took me to the local physician who gave me an injection (I do not know the name) and told my dad that it was epilepsy attack or fit hence take me to a neurologist as soon as possible and next day I was admitted to a nearby hospital where were done many a test which are elaborated herein for your kind pursuance:
    X-RAY REPORT OF CHEST
    Lung fields are clear.
    Cardiac size and configuration normal
    Apices and cp angles are clear
    (Please correlate clinically and further investigate to assess if need be)

    EEG REPORT
    awake EEG shows background consisting of 8-9Hz posteriorly dominant alpha rhythm.
    no focal slowing is seen
    left frontoparietal slow and sharp waves discharges are seen
    no epileptiform discharges are seen
    sleep not obtained

    IMPRESSION-: abnormal awake EEG record suggestive of localization related epilepsy arising from LEF frontoparietal area.
    suggestive neuroimaging
    to be correlated clinically

    MRI REPORTS
    Both orbits are normal.
    note is made of mild pansinusitis.
    IMPRESSION-:
    MR IMAGING OF BRAIN REVEALS FOCAL HYPOINTENSE NODULE LOCATED SUPERFICIALLY AT GREY WHITE MATTER INTERFACE IN LEFT FRONTAL LOBE WITH SURROUNDING MILD EDEMA/GLIOSIS, SUGGESTIVE OF INFLAMMATORY GRANULOMA.
    ADVISED: CLINICAL CORRELATION.

    MRI BRAIN
    FLAIR T1W AND FAST SPIN ECHO T2W HIGH RESOLUTION AXIAL IMAGES OF BRAIN WERE OBTAINED ON A HIGH RESOLUTION DEDICATED PHASED ARRAY SURFACE COIL USING TWIN GRADIENT 8 CHANNEL HIGH DENSITY 1.5 TESLA SYSTEM WITH ZOOM GRADIENT COIL AND CORRELATED WITH T2W SAGITTAL,CORONAL,FLAIR AND DIFFUSION AXIAL IMAGES.
    SUPRATENTORIAL:
    THE STUDY REVEALS FOCAL HYPOINTENSE NODULE LOCATED SUPERFICIALLY AT GREY WHITE MATTER INTERFACE IN LEFT FRONTAL LOBE WITH SURROUNDING MILD FLAIR HYPERINTENSITY SUGGESTIVE OF EDEMA.
    REST OF THE CEREBRAL PARENCHYMA IS NORMAL IN SIGNAL INTENSITY WITH MAINTAINED GEY AND WHITE MATTER DIFFERENTIATION.
    BILATERAL BASAL GANGLIA AND THALAMI ARE NORMAL IN VOLUME AND SIGNAL INTENSITY.
    VENTRICLES ARE NORMAL IN SHAPE,SIZE OUTLINE AND VOLUME. SEPTUM IS IN MIDLINE.
    BASAL CISTERNS AND SYLVIAN FISSURES ARE NORMAL.
    SELLA AND PARASELLAR REGION ARE NORMAL.
    POSTERIOR FOSSA:
    BRAINSTEM IS CENTRAL AND NORMAL IN SIGNAL INTENSITY.
    FOURTH VENTRICLE IS CENTRAL AND NORMAL.
    CEREBELLUM IS NORMAL IN SIGNAL INTENSITY.
    MAJOR INTRACRANIAL FLOW VOIDS PRESERVED.
    HAEMATOLOGY
    complete blood count
    Haemoglobin 14.3%
    total leucocyte count 9600
    DIFFERENTIAL LEUCOCYTE COUNT (DLC)

    Neutrophils 75

    Basophils 00

    Eosinophils 02

    Lymphocytes 20

    Monocytes 03

    RBC count 5.11

    PACKED CELL VOLUME (PCV) 44.8

    MCV 87.67

    MCH 27.98

    MCHC 31.92

    PLATELET COUNT 1.86

    KIDNEY FUNTION TEST (KFT)

    UREA-13.85
    SERUM CREATININE-0.75
    SERUM URIC ACID-7.55
    CHOLESTEROL-148
    ALKALINE PHOSPHATASE-93
    SODIUM-140
    POTASSIUM-3.7
    CALCIUM-9.0
    PHOSPHORUS (PO4)-3.81
    TOTAL PROTEINS-7.94
    SERUM ALBUMIN-4.94
    GLOBULIN-3

    LIVER FUNCTION TEST

    TOTAL BILIRUBIN-0.87
    DIRECT BILIRUBIN-0.39
    INDIRECT BILIRUBIN-0.48
    S.G.O.T-52
    S.G.P.T-77
    G.G.T-123
    ALKALINE PHOSPHATASE-93
    TOTAL PROTEINS-7.94
    SERUM ALBUMIN-4.94
    GLOBULIN-3
    A/G RATIO-1.65
    (note: the results which were obtained have been only mentioned just before every organical or test work name and those which have been underlined and are in bold font having the same expression as mentioned in the report )

    DISCHARGE SUMMARY
    case summary
    patient admitted with complaints of seizurex4 days at 3 episodes cannot movement of body towards right at the time of seizure.
    initial examination revealed…………………….
    conscious , oriented
    afebrile
    BP 130/80 mmHg
    PR 100/min
    chest-bilateral air entry (+)
    CVS-S1 S2 (+)
    PA-soft, BS (+)
    after initial clinical assessment treatment initiated and all necessary investigations were sent. patient shifted to ward for further management under neurologist Dr. R.K .Gupta.
    in the ward patient was reassessed and treatment continued with supportive care and enteral nutrition. gradually patient’s condition stabillised and is being discharged in a stable condition with follow up medical advice.
    TREATMENT GIVEN

    INJ-FOSOLIN
    INJ-DEXONA
    INJ-PANTOCID
    INJ-ONDEM
    TAB-FRISIUM
    TAB-ZEPIZ 0.5MG
    TAB-OLIZA
    TAB-EPTOIN
    TAB-PANTOCID
    TAB-OLANZAPINE 2.5MG

    INVESTIGATIONS
    LFT- S.BIL-NORMAL, SGOT52, SGPT77, GGT123
    KFT-NORMAL, URIC ACID 7.55 , HB 14.3 , TLC9600, P/C1.86
    ECG-S/O LOCALIZATION RELATED EPILEPSPSY ARISING FROM LEFT FRONTO PARIETAL AREA
    X-RAY CHEST
    MRI S/O INFLAMMATORY GRANULOMA

    MY PRESENT STATE OF MIND
    sir at present I have been taking the following medicines as referred by my doctor:
    TAB-FRISIUM
    TAB-ZEPIZ 0.5MG
    TAB-OLIZA
    TAB-EPTOIN
    TAB-PANTOCID
    TAB-OLANZAPINE 2.5MG
    and there is another one which is rolled shape small resembles eggs

    MY DOCTOR’S SUGGESTIONS
    1- I cannot drive at least for 6 months
    2- I need to take these medicines at least for 6 months
    3- I cannot drink
    4- I can’t do exercises or yoga

    ALL THAT IS SPECIAL AND SECRET THAT I WISH TO SHARE WITH YOU SO THAT YOU COULD HELP ME OUT
     I do exercise and yoga at home for an our everyday
     I go to my bed around 4-5 am every night
     I take half bottle of whisky everyday (just from few months back only) and I have such a capacity and self confidence that if I want I can leave it instantly and I have tested it many a time
     the nature of my job entitles only be waken till late in night
     few years ago I suffered from the infection in my LS joints or say BONE T.B
     while I was in 5th standard the same attacks or say fits I experienced and the same way neck kept moving right hand side but that time I had easily controlled but this time it became uncontrollable for me. why ?
     I have been yoga instructor for the long time till date
     some times I feel that my mind has become overactive which I cannot control
     I take tobacco everyday
     I am in contacts with lots of women and girls and keep thinking about them
     I have lots of tensions in my mind regarding my family and my enemies
     I feel that most of the time my mind keeps thinking unnecessarily .
     I am a role model for all of my friends, students, relatives and neighbors as well as I am honored at large
     Some times I feel that I must commit suicide since my mother passed away few months ago only and she comes in my dreams everynight

    WELL THESE ALL ARE THE POINTS WHICH ARE ABSOLUTELY TRUE SINCE IF A PATIENT HIDES ANY THING FROM HIS DOCTOR THEN HE/SHE CANNOT BE EVERY PROPERLY TREATED AND THESE ARE THE FACTS WHICH I EVEN NEVER SHARED WITH MY NEAR AND DEARONE….PLEASE HELP ME OUT AND CLEARLY TELL ME WHY THIS PROBLEM HAPPENED TO ME AND WHY DOCTOR HAS PUT SUCH RESTRICTIONS ON ME…PLEASE SIR HELP ME OUT..

  108. Dear Costa,
    seizures provoked by medications are well known as some medications lowere the seizure threshold of the brain. Whether you need to remain on long term anticonvulsant therapy is determined by history and the results of tests like MRI brain and EEG. Your doctor shall be the best person to determine whether you have underlying epilepsy (and thus need to remain on long term anticonvulsant therapy) or whether you suffered a single provoked seizure due to Tramadol.

    Personal Regards,

    Nitin K Sethi, MD

    • Hi Nitin,

      Thanks for your reply and being very kind to us.

      Great if you could give your opinion on this. I am away from the country now and cannot visit my doc fro another week. As I have stated earlier I have been on Phenytoin(100mg) twice a day(Morning and Evening) and feel very drowsy and tired the whole day. Even after sleeping for 10hours and over. Also, I do not have a sound sleep with weird dreams and people around told me I am talking when sleeping. I work for a top ten management consulting companies and so have to be agile and sharp in thinking. I think may be Phenytoin is the reason for this. Will see my doc in a week but, thought of getting to know your opinion(he initially advised to taper this after 4 weeks and stop. I am really worried whether Seizure will re-occur if I stop Phenytion. Can drug(Tramadol) induced seizure be one-off?

      My EEG Report says – Background activity is formed by 8-9Hz bilaterally
      CT – Linear hyperdensity in right slyvian fissure M2 segment MCA

      These were taken withi n 30 min of that seizure event!.. Looking forward for your opinion on how serious this is.

      Once again many thanks for all the help.

      Kind regards,
      C

  109. My husband is alcoholic. Eight yrs. ago he had an incident where he was unable to speak for approx. 1 minute. He saw doctors & had all kinds of tests done & they said it was a T.I.A. We relocated & doctors in N.Y. said it was a seizure disorder, not a T.I.A. Neurologist put him on 600 mg. of Tegretol XR per day plus gave him Lorazapam for his tremor. He recently broke his arm due to a fall at home. His walking is very unstable, he never feels well, he doesn’t socialize anymore & lately I notice he’s having trouble with his eyes. Don’t know where to go to get him the help he needs. He’s only 66 yrs. old.. Any advice please?

    • Dear Maureen,
      thank you for writing in. I am sorry that you find yourself in these tough times. My one advice after reading your email is to address your husband’s alcohol problem if that is still indeed a problem. Now that may be easier said than done but needs to be addressed since the question which certainly comes to mind is whether your husband’s seizure disorder and tremors are both due to excessive alcohol intake.

      Personal Regards,

      Nitin K Sethi, MD

  110. i have been taking anti-seizure medication my last seizure without taking medicine was a year earlier i troubled with a question lately can we drink alcohol moderately or complete abstinence is required

    • Dear Itssrijana,
      thank you for writing in to me. People with seizures can certainly enjoy a drink though I usually advice my patients to abstain from alcohol if possible.

      Personal Regards,

      Nitin K Sethi, MD

  111. I am a 20 year boy. I had seizure at the age of 13 , and i was on medication for 4 years (carbamazipine). After 4 years docotor adviced me to stop medication by slow reduction of dose i stoped it in 2-3 months , but seizure again occured for me .then i again started with the same drug with same dose (300 mg/day)under doctors advice…. I am having a dought that whether the second seizure was a withdrawel seizure ?….. Whether i can drink beer (not more than 1 botle, not occationaly ) ?

    • Dear Fijo,
      I usually advice my seizure patients to drink in extreme moderation or if possible not to drink at all. Talk to your doctor about this and follow his advice.

      Nitin K Sethi, MD

  112. I just quit abruptly yesterday, after about 5 years of daily heavy drinking (around 18 a day), and I’m really scared because my chest hurts & my heart won’t slow down & my legs & wrists keep twitching real hard. I woke up once & my legs were convulsing. All my muscles are tight & twitchy. I don’t have anyway to get to the hospital because I can’t get on the subway like this, or even go outside, & I live alone. I hope it doesn’t get worse. I hope it starts getting better, it’s been 24 hrs.

    • Dear Nes,
      thank you for writing in. I have only one advice to you. Go to the nearest hospital’s ER. Abruptly quitting alcohol especially if one has been drinking heavily for many years is ill-advised. You risk having alcohol withdrawal symptoms, delirium tremens and even seizures. So have a family member or friend take you to the ER.

      Nitin K Sethi, MD

  113. Should someone seek medical advice post a ‘rum fit’? If it has happened more than once should I be worried, as it has happened to my partner, he is a heavy binge drinker at weekends. Thank you

  114. Well, I’ve been a drinker for a couple of years now. And just recently (week ago) I made a command decision to just flat out stop drinking. I did most of my drinking on weekends, so I’d binge… a lot. I generally felt alright the whole week, just my anxiety was spiked up a little more than usually. So exactly a week later, I had a seizure at work. They took me to the the hospital, ran all sorts of tests and were able to tell me nothing. They said there was nothing wrong in any of the tests, so is it possible to have a withdraw like seizure a week after your last drink?? Because I’ve NEVER had seizures or anything like that before all of this. Some people said it was because I had 2 Rockstar energy drinks on an empty stomach, I’ve drank way more caffeine than that and all that happened ever was bad hyperglycemia… I think it was alcohol induced honestly…. any thoughts? Thanks!

  115. I’m not a heavy drinker, but I seem to have “rum fits” when I drink. it’s happened twice now. does that mean i’m intolerant to alcohol?

  116. I developed an occipital lobe seizure disorder after getting Serotonin Syndrome from chronic alcohol use with the SSRI tramadol. I haven’t drank since

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