Neurológia pre prax 4/2013

Alcohol and epilepsy – how to treat?

Alcohol consumption is very high in the Czech Republic and this gives rise to a considerable public health problem. The link between epilepsy and alcohol consumption is definite. Epileptic seizures are three times more frequent in abusers and increase with the amount per day of alcohol consumed. Both intoxication and withdrawal are recorded as the risk factors, but the withdrawal seizures attracts the most of attention. Long-term alcohol abuse impairs regulation of the NMDA and GABA-A receptors. The sudden deficit of alcohol results in alcohol withdrawal seizures. A manifestation of alcoholic epilepsy varies with respect to length of abuse. There are seizures related to withdrawal period at the first stage, seizures appearance in both withdrawal phase and consumption phase at the second stage and finally irreversible third stage of alcoholic epilepsy (Bartolomei, 2006). Epilepsy suffered by alcohol abusers can also have the same kinds of etiology as it has in general population (e.g.post-traumatic, post-stroke etc.) The chronic alcohol abuse influences also the metabolism of an AED that reduces level of the AED within the blood plasma. The repeatedly abstaining abusers (may be for the treatment of abuse) should be observed carefully. Recent studies conclude the antiepileptic treatment of alcohol abusers is necessary. However, the epilepsy and alcohol abuse treatment should be linked together.

Keywords: alcoholic epilepsy, etiology, treatement, AED, blood plasma levels.