Alcoholic epilepsy: symptoms, causes, treatment, consequences of seizures

The development of seizures is preceded by a change in the structure of brain cells, a violation of their membrane permeability, the pathology of gas exchange and metabolic processes. Neurons are subject to destruction.At the heart of this destruction is the toxic effect of alcohol products.The brain tissue is the most sensitive to the effects of these poisons.

The longer a patient takes alcohol, the higher his chances of developing epilepsy.Especially, the danger of its manifestation is growing as a result of the reception of poor-quality alcohol.

Additional factors contributing to the onset of seizure manifestations are:

• head trauma;
• disorders of cerebral circulation;
• severe infectious diseases;
• tumor processes.

Classification criteria

Domestic scientist Zhislin SGIn his works notes that seizures characteristic for alcoholic epilepsy develop only:

• after alcoholization, or at the altitude of withdrawal or hangover syndrome, for several days after the last intake of alcohol;
• in the development of alcohol delirium and encephalopathy of Gaye-Wernicke.

Note: epileptopodobnye attacks at the height of intoxication are often "pseudo" character and are peculiar to people with a hysterical personality.

Currently, convulsive epileptiform manifestations in alcoholism are defined as follows:

• epileptic reaction is a seizure that looks like an epileptic that occurs in people who do not have alcohol dependence, accidentally drinking.As a rule, the attack begins the next day, preceding a massive alcoholization.After removing poisons from the body - no longer repeated;
• epileptic syndrome is a more serious form of convulsive condition.Before the attack, aura can appear in the form of psychic - illusory, and hallucinogenic manifestations, vegetative disorders - sweating, headache, chills, etc.Seizures can be multiple;
• alcoholic epilepsy. Strictly speaking, this is the manifestation of true alcoholic epilepsy.The patient has a long alkostage, a neglected stage of alcoholism, binges.Often, against the background of alcohol-epilepsy, psychoses develop.

Diagnosis of alcohol epilepsy

The disease is determined based on a survey and examination of the patient.The doctor checks the tendon and oculomotor reflexes. An encephalographic study is mandatory, which can immediately determine the nature of epilepsy. With its alcoholic variant, there are no usual anomalies inherent in the true( genoinic disease).Patients with alcoholics are characterized by the usual rhythms of brain biocurrents for their age category.

Note: a characteristic feature of alcohol epilepsy is its complete disappearance with prolonged abstinence from alcohol.

In patients of the older age group with a neglected form of alcohol dependence, seizures against the sobriety background may not disappear completely, but in any case - will become less frequent.

The doctor should be aware of possible symptomatic epilepsies caused by other causes, or a true disease when diagnosing.In this case, with prolonged sobriety, seizures do not disappear and require therapy of the underlying pathology.

All patients have varying degrees of progressive dementia( dementia).

CT scans( CT) or MRI of the brain determine the expansion of the lateral ventricles of the brain.

Symptoms of alcoholic epilepsy

Most often, patients develop single or generalized seizures.Outwardly, they resemble large epileptic seizures, going in a short series.

In mild forms of malaise, there are non-convulsive paroxysms, with brief disturbances of consciousness, or simply manifestations of the psychoneurological aura.There may be a variant with periodically repeating movements of the whole body, limbs.The attack can be accompanied by sudden changes in mood.An important feature is the consistency of the clinical picture.Attacks proceed always in the same version, without new manifestations.

Seizure of classical alcoholic epilepsy in patients:

• short-term manifestation of the aura, pallor of the skin, especially the face, hands, trunk;
• attack begins with a patient falling with a pronounced head tilt.Unlike "hysterical epilepsy" the patient falls in any place, including dangerous. The hysterical will always fall accurately, not wreaking havoc, although the apparently inexperienced person will not notice a special difference;
• phase of tonic convulsions - pulling the patient "into a string"( in comparison with true epilepsy - there is a longer duration of this period of time) passes with moaning, gnashing of teeth.In some cases, the patient has sphincter disorders( involuntary discharge of urine), respiratory failure;
• phase of clonic convulsions( rhythmic, large-amplitude jerking of the body, limbs), in time - shorter than with genuine( true) epilepsy.

Rarely, an epileptic seizure can occur in the form of an "absense" - a sudden "shutdown" of consciousness for a short time.There are unusual types of seizures, accompanied by episodes with repetition of phrases, often without matching events.Such manifestations of epilepsy are little known to most people and are not perceived by them as painful deviations of convulsive origin.

Note: is a distinctive feature of alcoholic epilepsy from the true, is the development of insomnia in the first case, a dream with a fantastic component.In patients with epilepsy( mental illness), after a seizure, a dream occurs, after which they remember nothing in the interval between the attack and awakening.

The increasing frequency of seizures of alcoholic epilepsy indicates a progression of pathology. Increasingly, after an attack, there is a delirious state with frightening hallucinations of a fantastic nature( demonic creatures, extraterrestrial beings, etc.)

Treatment of alcoholic epilepsy

The main thing that helps to eliminate the problem of attacks is the cessation of the intake of alcohol in the body.Therefore, the causal treatment is active antialcohol therapy.

In severe cases of alcoholic epilepsy, the following are used:

• dehydration of the body( elimination of excess fluid and purification from poisons);
• resorption therapy;
• normalization of acid-base, enzymatic and hormonal balance, which contribute to the restoration of brain neurodynamics and metabolic processes;
• anticonvulsant preparations;
• psychotropic drugs.

Please note: should not somehow restrain convulsive movements during first aid, insert a spatula into the mouth, etc.These manipulations can aggravate an attack and cause an epileptic status( a complication in which one attack is layered on another).

All you need is to ensure the safety of the patient so that he does not get damaged.If the patient does not come to consciousness after an attack, you should give him a safe pose.

Convulsive manifestations require the provision of treatment in three stages:

• is the individual choice of the most suitable, tolerable and most effective drug that helps treat attacks;
• selection of the dose of medication and other methods that will contribute to the formation of a long period of remission, reduce the possibility of recurrence of seizures;
• smooth reduction of doses, or complete cancellation of medicines.

Important : treatment for alcoholic epilepsy is carried out in a complex way, individually, continuously.Be sure to take into account the age of the patient, the characteristics of the seizures.

In the selection of essential medicines, the experience and intuition of the physician plays an enormous role, which adjusts doses based on personal observation data.It is the narcologist who sees possible manifestations of addiction to the medicine.Against this background, there is a decrease in the effectiveness of therapy.The specialist in these cases smoothly removes the doses of the used drugs and introduces new medicines.

The most commonly used anticonvulsant carbamazepine.Phenobarbital, effective for true epilepsy, is limited in admission to the characteristics of alcoholism and is prescribed in exceptional cases.

The drugs of choice for the treatment of major seizures are:

• Hexamidine;
• Diphenine;
• Benzonale;
• Morxsymide.

Additional, but important, is the use of the tranquilizers .

For small seizures, the doctor is limited to the appointment: Trimetine, Diphenine, Diamox.

Alcoholic epilepsy, combined with delirium, twilight states, requires the appointment of neuroleptics.

With severe mental depression, antidepressants are added to the therapeutic complex.

For all types of alcohol epilepsy, patients undergo psychotherapy.Setting for sobriety is the most important and promising way to recover .To remove the negative phenomena of apathy, sensations of meaninglessness of life, with patients, conduct all possible types of psychotherapy.The most effective group forms of rational belief.

The effect is fixed by hypnotic treatment.The most optimal can be considered the result, in which the patient self-expressed desire and passed the coding from alcoholism.

Physiotherapy should be used with extreme caution, because of its possible effect on increasing the seizure activity of .All electroprocedures, acupuncture is prescribed after careful examination and observation of the patient by a neurologist.

Prognosis and prevention

The best preventive against repeated seizures of alcohol epilepsy is sobriety.For preventive maintenance, methods of restorative therapy are used.Very good effect gives a temporary stay of a person in a rehabilitation center.Constant attention from specialists, communication with people who have got rid of a similar problem, a gradual return of physical strength and mental health is the best way to regain a normal life.Getting rid of alcoholic epilepsy is included in a large complex of medical and recreational activities in the treatment of alcoholism.

Alexander Lotin, medical reviewer