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Alcoholic epilepsy: signs before a seizure

 
, medical expert
Last reviewed: 04.07.2025
 
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Today, the problem of alcoholism and its consequences for the body is acute all over the world. According to statistics, there is always a certain percentage of alcoholics in society. But even among them there is a certain percentage of people who are in a particularly severe, critical condition. One of these conditions is alcoholic epilepsy, which is a severe disease accompanied by attacks and convulsive seizures.

This condition can be explained by severe pathological changes in the brain that occur with prolonged alcohol consumption. At first, the exacerbation occurs when a person drinks alcohol, then it can be observed during the period when a person does not drink alcohol.

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Epidemiology

According to various types of statistical data, alcohol epilepsy is diagnosed in approximately 2-5% of people who abuse alcohol for a fairly long time. Of these, approximately 15% develop pronounced personality disorders. The disease affects both men and women equally. At the same time, 75% of those suffering from epilepsy abuse alcohol for 5 years or more.

As practice confirms, it is impossible to cure epilepsy completely. Thus, in 98% of cases it is not cured, or develops again with the use of even a small amount of alcohol. One seizure is always followed by another, they are never isolated. It has also been established that 70% of patients have normal mental health, 20% have a decrease in intelligence, dementia, 10% have moderate or obvious mental deviations.

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Causes alcoholic epilepsy

The main causes of severe brain pathology are long-term alcohol consumption. Also, craniocerebral trauma, infections and inflammatory processes, atherosclerosis serve as a trigger mechanism in the development of epileptic seizures.

The cause may also be a previous epileptic seizure, which provoked irreversible changes in the cerebral cortex. These are the ones that subsequently cause new seizures to develop. It has been established that there are no isolated seizures. If there was one, then sooner or later a new one will definitely follow. Over time, seizures tend to only become more frequent and severe, and to occur at any time, regardless of whether the person has drunk anything or not.

Risk factors

The risk group includes people who abuse alcohol: who drink in large quantities, over a long period of time. Also at risk are people who drink cheap and low-quality types of alcohol, mixtures, surrogates, counterfeits. There is also a high risk of developing a repeated attack, if one has already been observed.

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Pathogenesis

The pathogenesis is based on a pathological change in the structure and function of the brain. First of all, interneuronal connections in the cerebral cortex and subcortical structures are disrupted. Synapses between neurons, neurons themselves, are gradually destroyed. The most dangerous is considered to be a violation of the hypothalamic-pituitary system, neuroendocrine regulation.

A surge in epileptic activity is associated with a reaction of cellular and tissue structures of the brain. It is often a consequence of excessive excitation or irritation, especially when exposed to toxins and high temperatures.

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Symptoms alcoholic epilepsy

The main symptoms are fainting and sudden loss of consciousness, cramps and burning pain. All this is also accompanied by a feeling of compression, twisting of the muscles of the limbs, less often - the neck. In severe cases of the disease, when it becomes chronic, attacks can recur again and again, even several times during one day. Alcoholics often feel burning, pain and swelling in the limbs, without cramps.

Often, seizures are accompanied by attacks, hallucinations, which are typical for alcoholics. This occurs especially often when alcoholics gather all their willpower and quit drinking on their own. In this case, the seizure develops as a reaction of the brain, after several days. Sleep is disturbed, alcoholic delirium continues to progress: the person begins to rave, chills appear, body temperature rises. The patient becomes aggressive, angry, touchy, picky. Concentration of attention decreases sharply, personality degradation occurs.

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First signs

Clinical manifestations of alcoholic epilepsy are similar to those of ordinary epilepsy. However, it still has its own characteristic features. The person becomes aggressive, embittered, finds fault with everything. Behavior, coordination of movements, speech and sleep are gradually disrupted. Very colorful, quite realistic pictures, visions, dreams may appear. The person becomes emotionally overexcited, unrestrained.

The fact that a seizure has already begun or will soon begin is indicated by strong muscle cramps, the entire chest is squeezed by a spasm, breathing becomes hoarse, lips turn blue, skin becomes pale. Some people experience nausea, less often - vomiting, a feeling of lack of air, pain in various parts of the body.

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Precursors of alcoholic epilepsy

At first glance, it seems that epileptic seizures begin suddenly and frighteningly. However, this is far from true. Seizures are never sudden, they have many precursors. First, there is a sharp increase in a person's sensitivity and susceptibility, a feeling of cold appears, which is suddenly replaced by heat.

Visual sensations also change: various "dots" and "figures" may appear before the eyes. A person cannot accurately perceive objects located in front of him, has incorrect ideas about the relationship of distances, objects, images, and sometimes the spatial-temporal connection is lost. General well-being noticeably worsens, headaches, sleep disturbances, weakness, fatigue, and depression of mood appear. A feeling of melancholy, sadness, and apathy may come over him without reason.

The person experiences sharp mood swings: from sharply positive to extremely negative, up to suicidal thoughts. Auditory hallucinations often appear, thirst may increase, immunity may rise or, on the contrary, sharply decrease. With severe intoxication, chills appear, body temperature rises.

Immediately before the attack, the person usually screams loudly, then falls to the floor, begins to convulse and spasm. The cause of the scream is often a spasm of the glottis, as well as spasms in the chest muscles. Harbingers of the onset of the attack may occur several days before its manifestation.

Stages

There are several stages of the disease development. First, an epileptic reaction appears, which manifests itself as a seizure. Outwardly, it differs little from a normal epileptic seizure. Quite often it occurs in people who are not subject to alcohol and drug addiction, but are simply occasional consumers of alcohol. As a rule, the attack occurs the next day. Very often it is observed after mass holidays, festivities in a certain percentage of the drinking population. The cause is usually excessive alcohol consumption, or consumption of low-quality drinks. Sometimes - an admixture of light drugs, spice. Such epilepsy is easily eliminated, mainly immediately after the toxic substance is removed from the body, as a rule, repeated attacks do not occur.

The second stage is the development of epileptic syndrome, in which a convulsive state develops. A person develops an aura in the form of mental disorders, which are represented by various illusory and hallucinogenic ideas. Vegetative disorders gradually join in, in particular, sweating, headache, chills. Seizures, as a rule, are not single. Multiple cases almost always develop.

The third stage is alcoholic epilepsy. This is the most severe stage, which is a manifestation of true alcoholism. It occurs in patients with a long history of alcoholism, who drink alcohol regularly, for more than 5 years. This is an advanced stage of the pathology, in which frequent binges occur, and psychosis develops.

Symptoms of alcoholic epilepsy before an attack

Some time before the attack, precursors of the attack develop: the person's emotional background changes sharply, the person becomes sluggish, apathetic, or, conversely, aggressive, embittered. The person's health deteriorates sharply: nausea, vomiting may begin, general weakness, chills, and shortness of breath appear. After this, the person falls to the floor, convulsions begin, and saliva is released. In general, the signs resemble those during the development of an epileptic seizure.

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Attack of alcoholic epilepsy

The attack develops in several stages. First, the state of the central nervous system changes abruptly, the cerebral cortex is affected, and the innervation of the main structures is disrupted. Against this background, convulsive syndromes develop, abnormal muscle contractions, involuntary body movements, hyperkinesis, and paresis appear. Both skeletal muscles and facial muscles are affected.

At this stage, it is important to conduct a correct diagnosis, so the person needs to stop drinking, gather willpower and go to the doctor. It is necessary to conduct a differential diagnosis, accurately differentiate alcoholic convulsive syndrome from convulsions that occur under the influence of various unfavorable factors, or as a side effect of concomitant diseases. It is important to distinguish from an epileptic seizure.

When all other diseases with similar clinical manifestations are excluded, a diagnosis of alcoholic epilepsy is made. In most cases, the basis for the diagnosis is a long-term binge, constant alcohol abuse over several years. Radical changes in the brain also occur.

The attack itself manifests itself as a convulsive seizure, which manifests itself in the form of involuntary contractions of the entire body, convulsions of not only the limbs, but also individual parts of the body. Also, such attacks can be provoked by a strong emotional outburst, stress.

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Forms

The classification of epilepsy is based on the extent of the lesion and the characteristics of the pathological process. There are 5 main types of epilepsy.

The idiopathic form implies a form of pathology in which the cause is not exactly clear. This includes cases in which a person has not consumed alcoholic beverages for a long time, but the attacks continue.

In the cryptogenic form, it is known for sure that there is a certain reason for the attacks, but it is not possible to differentiate it precisely. This may be a reaction not only to alcohol, but also the result of various injuries, damage, and progressive pathologies of the brain.

Symptomatic epilepsy is secondary, with one seizure recorded, during which irreversible damage occurred in the cerebral cortex. After that, repeated, multiple seizures occur.

In generalized pathology, the entire brain is involved in the manifestation of an attack; it is not possible to clearly determine the cause and localization of the pathological process.

Focal epilepsy is a pathology in which the development of the pathological process occurs exclusively as a result of damage to a certain one or several areas of the brain. Damage usually occurs as a result of prolonged exposure of the brain to alcohol, the intake of low-quality alcohol, as a result of which pathological processes develop.

Complications and consequences

The consequences of alcoholic epilepsy are very serious. The disease is incurable. First of all, this disease implies disorders in the brain, which entail further failures in the nervous and endocrine systems, decreased immunity, as well as disruption of the normal functioning of all organs and systems of the body. Pathologies progress, overlap, and ultimately lead to fatal diseases that cannot be treated. Quite often, infectious diseases develop against the background of decreased immunity.

A dangerous complication is the development of epileptic status, which results in frequent, regular convulsions, gradually leading to the development of cerebral edema and deep coma. Breathing and heart function may stop. Epileptic status is treated exclusively in a hospital. If deterioration occurs, you need to call an ambulance as soon as possible.

Another side of epilepsy of alcoholic genesis is the profound psychological changes that occur with a person. Epilepsy is often accompanied by personality disorders, in which a person changes beyond recognition. A person loses all interest in work, all his attention is focused either on drinking or on its consequences.

The ability to work decreases sharply. The person is unable to perform even the most basic tasks, and cannot concentrate. The productivity of work, time expenditures, and concentration of attention decrease sharply. The person cannot communicate with people around him, loses communication skills, is unable to adequately assess criticism, becomes aggressive, harsh, and rude. At home and at work, he initiates scandals, often takes unreasonable offense, or blames others. Usually, such a state is no longer subject to change.

The attack itself is also dangerous. Any attack in a state of alcoholic intoxication can end in death. Most often in such cases, people die from blows during convulsions. A person can also choke on their own saliva, foam or vomit during a convulsion. They can bite their tongue, which results in massive bleeding, which is very difficult and almost impossible to stop. A person can choke by swallowing their tongue.

The consequences of seizures are no less dangerous. The most dangerous is the development of alcoholic delirium, the occurrence of hallucinations. This condition is dangerous not only for the person himself, but also for the people around him. During and after a seizure, many alcoholics become aggressive, lose control of themselves, they develop obsessive ideas, visions. Sometimes manic, suicidal tendencies arise. Over time, alcoholic epilepsy, if left untreated, can lead to the development of antisocial behavior, as well as to the degradation of the nervous system and the destruction of all internal organs.

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Diagnostics alcoholic epilepsy

To diagnose the disease, you should contact a narcologist or neurologist. You can contact your local therapist, who will prescribe the necessary tests and send you to the right doctor. The doctor collects anamnesis of life: finds out general information about the person, collects information about education, work, conditions and characteristics of the person's life. It is important to know whether the person had similar problems before, before he became dependent on alcohol, how he treated alcohol before, and how the attitude has changed now. This can play an important role in making a diagnosis, choosing tactics and strategy of treatment, and will also allow you to choose the optimal psychological approach to the person.

The doctor also takes into account the medical history: how long ago the disease appeared, what are the features of its course, how the person reacts to the disease, whether he took any measures to quit drinking, to recover, what were the results. Were there previous epileptic seizures, how did they proceed, how long did they last, what measures were taken to stop them.

Then a survey and examination of the person is conducted, during which traditional, clinical research methods are used. Palpation, percussion, auscultation, thermometry, measurement of pulse, blood pressure, and other vital signs are performed. There are no special methods for diagnosing alcoholic epilepsy. If the data obtained is insufficient to make a definitive diagnosis, additional laboratory and instrumental studies are prescribed. Differential diagnostics are also performed.

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Tests

If necessary, tests are prescribed. In order to determine the general picture of the pathology, clinical tests of blood, urine, and feces are carried out. They can be very informative and can indicate the general direction of processes in the body, on the basis of which additional, clarifying tests can be planned, as well as a plan for further examination can be drawn up.

Thus, a blood test may show an increased number of leukocytes, lymphocytes in the blood, which indicates the development of a viral disease, an inflammatory process. To clarify the data, virological research methods, an immunogram can be prescribed. This will allow you to assess the state of immunity, blood composition, and assess the effect of alcohol on the body. Activation of a persistent infection, as well as the addition of a new one, the development of an infectious and inflammatory process as a result of this, is observed quite often, since alcohol significantly disrupts homeostasis, reduces the indicators of the immune system, non-specific resistance.

If the blood lymphocytes and neutrophils are elevated, this may indicate the development of a bacterial infection, the development of dysbacteriosis with a predominance of opportunistic strains, which occurs against the background of a decrease in immunity under the influence of alcohol. In this case, to clarify the data, a bacteriological study, an analysis for dysbacteriosis may be required.

An increased number of eosinophils indicates the development of an allergic reaction, increased sensitization of the body, excessive production of histamine and tissue mediators, basophils. This is observed in allergies, parasitic and invasive diseases, autoimmune pathologies. Quite often, these reactions develop in response to alcohol consumption, since it acts as a toxin and allergen. An increased number of lymphocytes and eosinophils may indicate severe intoxication of the body and serves as a reason for conducting a study of sensitivity to allergens (scarification tests are most often used), as well as an analysis for immunoglobulin E, which is an indicator of allergy. Also used, if necessary, an analysis to determine the level of immunoglobulins A, G, which indicate the state of local immunity of the mucous membranes. This can provide a lot of information in determining the stage, features of the course of epilepsy.

The level of red blood cells will show the state of the hematopoietic system. A decrease may indicate the development of anemia, a violation of the hematopoietic function, the development of malignant tumors, bone marrow diseases. The level of platelets is one of the indicators of the blood's ability to clot.

Urine analysis can also track the functional state of the body. First of all, any pathologies will be accompanied by the appearance of additional salts and formations (oxalates, salicylates, bilirubin) in the urine. First of all, the analysis allows you to assess the condition of the kidneys and the entire urinary system. Indirectly, you can also judge the condition of the liver. This is very important, since these organs and systems suffer primarily from alcoholism. A large amount of protein, leukocytes in the urine indicate the development of an acute inflammatory process. A bad sign is the appearance of blood in the urine, which indicates severe degenerative changes in the kidneys and liver.

Stool analysis can also be very informative. It allows you to get a clinical picture of pathological processes occurring in the gastrointestinal tract, liver, which also suffer from alcohol. The mucous membrane degenerates, peristalsis and motility change, as well as the composition and amount of enzymes. Stool analysis can identify signs of dysbacteriosis, intestinal infection, the development of a malignant neoplasm, which quite often happens under the influence of alcohol. You can detect traces of blood, or detect hidden blood in the feces, which is also an extremely unfavorable sign that can indicate the development of necrotic, degenerative processes in the intestines, stomach.

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Instrumental diagnostics

If there is insufficient data and it is impossible to make an accurate diagnosis, additional methods are used. For example, an encephalographic study makes it possible to establish the nature of epilepsy. In epilepsy of alcoholic etiology, it is impossible to identify the usual anomalies inherent in the true form of the disease.

In patients suffering from alcoholism, despite the presence of seizures, normal rhythms of brain biocurrents are found that correspond to the age category. All patients show signs of dementia.

On a CT scan or MRI, one can detect an enlargement of the lateral ventricles of the brain, which is also a distinctive sign of alcohol pathology.

Differential diagnosis

Differential diagnostics is carried out to differentiate the signs of diseases that exhibit similar features. Thus, when signs of seizures are detected, it is important first of all to separate true epilepsy from alcoholic. This is easily done using instrumental research methods. The most informative can be an encephalogram, tomography. Alcoholic epilepsy is easily recognized by clinical signs. Thus, it can disappear after the elimination of the etiological factor, that is, with prolonged abstinence from alcohol consumption. Whereas true epilepsy does not disappear.

Treatment alcoholic epilepsy

The first step in treating alcoholism, and especially epilepsy of alcoholic genesis, is the voluntary and conscious desire of the patient himself. He must want to stop drinking, want to change something in his life. Without this point, there can be no talk of any recovery and progress in therapy. At this stage, a careful approach to the patient is required.

Read more about methods of treating alcoholic epilepsy here.

Prevention

The main preventive measure is to stop drinking alcohol and maintain a healthy lifestyle. It is necessary to follow all the doctor's recommendations, if necessary, attend consultations with a psychologist, group classes, and maintain a healthy lifestyle. In no case should the first attack be ignored. Only timely treatment can guarantee recovery and prevent the development of the next attack.

It is important to control blood sugar levels, constantly measure blood pressure, take the necessary medications aimed at combating alcoholism and seizures. It is important to normalize nutrition, exercise, and perform relaxing and breathing practices. Swimming and active sports are very useful.

How to avoid alcohol epilepsy after binge drinking?

Alcohol epilepsy can be avoided only after eliminating the main etiological factor of the disease - alcohol. If a person has just come out of a binge, the risk of an attack increases significantly. It can be avoided only if you gradually start doing light physical exercise and breathing correctly.

Relaxation exercises aimed at relaxing muscles and blood vessels can play a certain role. They should be combined with walks in the fresh air, proper nutrition, and vitamin intake. You can also take anticonvulsants, medications, and herbal decoctions aimed at normalizing the activity of the heart muscle and blood vessels of the brain.

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Forecast

The effectiveness of treatment depends primarily on the patient himself, since he must give up alcohol, and this must be a conscious decision. Usually, if a person does not drink alcohol and follows all the doctor's recommendations, the prognosis is favorable. Attacks can be prevented. Usually, at first they are repeated, but gradually become rarer and rarer, and subsequently disappear completely. If you do not follow the regimen and doctor's recommendations, drink alcohol during treatment, the prognosis can be extremely unfavorable, even fatal.

Life expectancy

Since the presence of epileptic seizures indicates organic damage to the brain, life expectancy may vary. Some people diagnosed with alcoholic epilepsy live quite a long time, but the quality of life is often greatly reduced. Firstly, brain damage always progresses, resulting in numerous lesions of internal organs, blood vessels, and mental disorders. It is also necessary to take into account that a person is constantly at risk, and each new attack can end in death for him.

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