Although most American adults drink in moderation, the Centers for Disease Control and Prevention (CDC) notes that there are 88,000 deaths every year on average due to excessive drinking. One in 10 of the deaths among working-aged adults, 20-64 years old, is caused by problem drinking in some form, with binge drinking, heavy drinking, and alcohol use disorder (AUD) being the most common. Among those who struggle with problem drinking, who do not suffer acute consequences like a car accident, long-term health conditions can develop, which can shorten life or reduce the quality of life.
Alcohol changes how neurotransmitters are released and absorbed by the brain. The intoxicating drink binds to the gamma-aminobutyric acid (GABA) receptors in the brain, leading to a feeling of relaxation as neurons fire less rapidly. The GABA neurotransmitter inhibits signaling between neurons. Too much GABA and a person will slur their speech, stumble, experience fatigue, or otherwise appear drunk; too little GABA, and neurons will fire rapidly, increasing anxiety, tension, the risk of insomnia, and the potential for seizures.
What Are Seizures?
A seizure occurs when several chemical changes happen in the brain, leading to a rapid firing of neurons and an increase in the brain’s electrical activity. There are several types of seizures that have different symptoms.
Focal seizures: These start in a specific area of the brain, and subcategories are named for the area where they originate. Focal seizures change feelings or physical experiences and may cause hallucinations. They are sometimes also called partial seizures, and about 60 percent of people with epilepsy have this form of seizure. Signs of a focal seizure can be mistaken for a mental illness like bipolar disorder or schizophrenia. Focal seizures include:
- Simple: These change how the world is perceived by altering how the brain processes sensory experiences. For example, the taste of food may change, or arms, fingers, or toes may twitch. There may be flashes of light in the vision, and the person may feel suddenly nauseated.
- Complex: These occur in the area of the brain controlling memory and emotion. Although the person may appear conscious, they are not (a stupor); they may smack their lips, gag, laugh randomly, or cry. It will take several minutes for this form of seizure to end.
- Secondary generalized: These begin as focal seizures but spread to both sides of the brain, which produces symptoms of generalized seizures, including thrashing or muscle slackness.
Generalized seizures: These are the stereotypical forms of seizures, involving muscle spasms, blacking out, and frothing at the mouth. Subtypes of generalized seizures include:
- Tonic-clonic/grand mal seizures: This form of seizure is the most apparent, and involves symptoms like thrashing, stiffened joints or muscles, loss of consciousness, and loss of bladder or bowel control. These usually last between one and three minutes; if they continue for longer, call 911 immediately.
- Clonic seizures: These are muscle spasms, especially in the face, neck, and arms, that can last for several minutes.
- Tonic seizures: Muscles in the arms, legs, and torso tense up. This lasts for about 20 seconds and typically happens when the person is asleep; if they occur while the person is awake and standing, they may fall over.
- Atonic seizures: Muscles suddenly go limp, and the head may fall forward. These last for about 15 seconds.
- Myoclonic seizures: Muscles suddenly jerk as if shocked. People often have both myoclonic and atonic seizures, although not at the same time.
Seizures are not a disease on their own; they are a serious symptom of an underlying condition, including epilepsy, brain development problems, brain damage, or withdrawal from some types of drugs, including alcohol. While alcohol abuse rarely triggers epilepsy or causes a seizure disorder, alcohol abuse is associated with changes in GABA production, which can increase the risk of seizures.
Alcohol Can Trigger Seizures in Several Ways
Moderate drinking does not trigger seizures, including in people who have epilepsy. One or two servings of alcohol, like a glass of wine or a bottle of beer, a few days per week is normal for most adults and can even be safe for people who are taking medication to prevent seizures with a doctor’s permission. If you are concerned about mixing alcohol with your epilepsy medication, talk to your doctor or simply avoid drinking altogether. Mixing alcohol and prescription medications can be very concerning, and anti-seizure medicines can make you more susceptible to the effects of alcohol.
However, too much alcohol in the body can trigger a seizure, and withdrawing from long-term alcohol abuse without help can lead to delirium tremens, which includes seizures as a symptom. Because alcohol changes how neurons fire, there are several ways that it can cause harm and lead to seizures.
Binge drinking: Drinking four or five servings of alcohol in a two-hour period is considered binge drinking. This amount of alcohol leads to being drunk because the liver does not process more than one serving of alcohol per hour. Continuing to drink more than one serving of alcohol for several hours can cause alcohol poisoning. Symptoms of alcohol poisoning include:
- Slow breathing
- Low body temperature
- Oxygen deprivation
- Passing out
Too much alcohol causes a drop in blood sugar, which can trigger seizures. These are usually in the form of status epilepticus, which are general seizures lasting longer than five minutes or several seizures that occur very close together. These seizures require emergency medical treatment because they can cause brain damage.
Delirium tremens: Trying to quit alcohol suddenly can cause a rapid change in brain chemistry, leading to withdrawal symptoms that can include insomnia and anxiety because neurons are firing quickly. High-volume, long-term alcohol consumption, which leads to physical dependence, may change brain chemistry so much that a condition called delirium tremens (DTs) will develop while you are trying to withdraw from alcohol abuse.
Delirium tremens develops 48-96 hours (two and four days) after you stop drinking and may last for two weeks. Delirium tremens is extremely dangerous, so you are at risk of death or chronic physical harm if you do not get help withdrawing from alcohol. Symptoms of delirium tremens include:
- Sudden, severe confusion
- Physical tremors
- Changes in mood and mental function
- Irritability, agitation, aggression, or paranoia
- Deep sleep for a day or more
- Intense excitement or fear and sudden bursts of energy
- Excessive sleepiness or fatigue
- Sensitivity to stimuli like light, sound, or touch
- Chest pain and irregular heartbeat
- Generalized seizures
The greatest risk of seizures during alcohol withdrawal occurs 12-48 hours after the last drink. People who have seizures because of alcohol withdrawal are at greater risk for experiencing seizures again if medication or drugs change their levels of GABA in the brain later in life.
It is important to get help to safely detox from alcohol use disorder (AUD). Medications like benzodiazepines and a tapering timeline developed by a medical professional can help you safely end physical dependence on alcohol and avoid DTs.
- Fetal alcohol spectrum disorders (FASD): When a pregnant woman drinks during pregnancy, her child is at risk for several of the mental, behavioral, and physical conditions in the group of fetal alcohol spectrum disorders (FASDs). These are developmental disorders caused by exposure to toxins in utero. About 2 percent of anyone with a developmental disorder will develop repeated seizures with no acute cause. Medical studies suggest that seizure disorders occur in 3-21 percent of people with FASD.
- Alcohol allergy/intolerance: Many people are mildly allergic to alcohol and can experience symptoms from drinking that include a blush or red flushing in the face, nasal congestion, increased heart rate, headaches, heartburn, and nausea. However, more severe forms of alcohol allergy can cause seizures, which may appear like alcohol poisoning seizures; most often, these involve convulsions and passing out. Emergency medical professionals should look for signs of allergic reactions when treating alcohol-related seizures, including rashes, hives, or facial swelling.
- Increased risk of triggering epilepsy: People who have a genetic risk or family history of seizure disorders like epilepsy, who become dependent on alcohol, may develop a seizure disorder through alcohol abuse. Once a person experiences a seizure, they are at risk for future seizures. If they do not stop binge or heavy drinking, they are at risk of suffering future seizures. Medical help to manage seizures and stop drinking is very important.
End Alcohol Dependence to Manage or Avoid Seizures
If you have a seizure disorder like epilepsy, follow your doctor’s instructions around prescription medication, lifestyle changes, and alcohol consumption. You may be able to drink moderately, but it is safer to avoid drinking altogether.
Those who struggle with alcohol abuse and problem drinking, including alcohol addiction, need professional help to safely detox from this drug and then enter a rehabilitation program to change behaviors. You must work with an addiction specialist to detox from alcohol because the risk of delirium tremens or alcohol poisoning during a relapse is high. If you have had a seizure due to alcohol abuse, stick with treatment in an evidence-based rehabilitation program to avoid future seizures.