Seizures When Undergoing an Alcohol Detox: Causes, Dangers & Treatments


Published On: October 20, 2023

When an individual has been drinking alcohol heavily for a long period, they can experience a whole range of unpleasant withdrawal symptoms when they stop or substantially reduce their intake.

In this blog, we will outline what you need to know about seizures, which can be one of the more alarming detox symptoms.

Firstly, what is an Alcohol Detox?

Two glasses of whisky being poured

Put simply, an alcohol detox is when a person whose body has adjusted to high alcohol consumption stops drinking or dramatically reduces their intake.

As an essential first step in treating alcohol addiction, it is a very positive and important process to undergo. However, it can bring about unpleasant and even dangerous side effects, which is why it must be done in a safe and informed way.

Why Does Alcohol Withdrawal Happen?

Alcohol addiction

Alcohol is a depressant, which means it slows down the activity of the brain and central nervous system. This is why a person who has consumed alcohol will experience such as slower thought processing and longer reaction times.

However, when a person consumes alcohol regularly and heavily, their nervous system will, in effect, begin to compensate for this, functioning in a heightened way to perform as well as possible despite the suppressing effects of alcohol. The brain will remain more alert, and nerves will fire faster.

As a result of this, even when the alcohol level drops, the brain will remain in a heightened state of alertness, known as hyper excitability or hyperirritability. As a result of this state, the brain will struggle to process information and regulate the nervous system effectively.

This effect is responsible for both the physical and psychological symptoms of withdrawal, including seizures.

When can Seizures Occur During Alcohol Withdrawal?

person lying in bed

It is difficult to predict how severe a person’s withdrawal symptoms may become during a detox, which is why it is essential to be well informed, well prepared, and always act under medical guidance.

Milder symptoms can be expected during the first day of detox and can commence as soon as six hours after finishing your last drink. Whilst unpleasant, these are unlikely to be dangerous and can include nausea, headaches, sweating and shaking, as well as heightened anxiety and increased irritability.

Twelve hours into a detox, more serious symptoms can begin to appear, and these commonly peak over the course of the second, third, and fourth day. This is when seizures are most likely to occur, along with physical symptoms such as high blood pressure and fever, as well as psychological symptoms such as insomnia, hallucinations andpsychosis.

In many cases, physical symptoms will then begin to ease over the fifth, sixth and seventh days, although psychological effects such as depression, anxiety and insomnia can remain for several weeks.

What are Delirium Tremens?

close up of face

Delirium Tremens (or DTs) are the most severe form of alcohol withdrawal and are very likely to develop if an individual is experiencing/ will experience seizures.

Delirium tremens will typically commence between the third and fifth day of detox, although they can commence even later in some cases. They can emerge suddenly and do pose a danger to life, so they should be taken seriously.

Symptoms of delirium tremens include severe confusion and paranoia, hallucinations, a racing or irregular pulse, uncontrollable shaking and breathing problems. More serious complications can include seizures, heart failure and coma. [1]

What Is a Seizure?

A man sweating

A seizure is an unusual but potentially dangerous medical complication in the brain. They usually occur in less than two minutes and are classed as a medical emergency if they last over five.

The NHS describes seizures as ‘bursts of electrical activity in the brain that temporarily affect how it works.’ [2]

As the brain’s function is founded upon the constant firing of electrical synapses, a disturbance to the electrical activity can be very serious, depending on how severe the disruption to communication is and which part of the brain is affected.

Why do Seizures Happen During an Alcohol Detox?

pulse trace and silhouette of person with glowing circle around heart

Seizures are most commonly experienced by people with epilepsy but can also be caused by injuries or illnesses which affect the brain. They are, therefore, commonly linked to the use of alcohol and drugs, and those undergoing an alcohol detox are at particular risk. [3]

As already explained, the withdrawal process is a dramatic destabilisation of the brain and central nervous system. Some withdrawal symptoms, in particular, can lead to a seizure during detox: heightened heart rate, heightened blood pressure and erratic electrical activity in the brain.

How Likely Am I to Experience Seizures During an Alcohol Detox?

blood pressure monitor on arm

Approximately one in ten people going through alcohol withdrawal will be affected by seizures. [4]

Whilst it is difficult to determine how severe an individual’s detox may be, there are some key indicators, including the individual’s age and health, how much alcohol they have been consuming and for how long, whether the individual has undergone any alcohol detoxes before, and whether the individual has a history of seizures or delirium tremens. [5]

However, even if an individual is a relatively low risk, they should not attempt a detox without medical advice. A detox in a medical environment such as a hospital or rehab facility might not be necessary for everyone, but medical support can also be provided for those detoxing at home.

What Types of Seizures are there?

Man lying down with his hand over his head

There are two broader categories of seizure a person can experience:

1. Focal Seizures

A focal seizure refers to abnormal electrical activity in one part of the brain. During a focal seizure, the affected individual may remain conscious or experience complete or partial loss of consciousness.

2. Generalised Seizures

A generalised seizure causes abnormal electrical activity in both hemispheres of the brain. These can include absence seizures, which result in loss of consciousness, clonic seizures, which result in jerking and spasming muscles; and tonic-clonic seizures, which cause loss of consciousness as well as convulsions.

What are Tonic-Clonic Seizures?

Woman slumped in a chair, feeling nauseous

Tonic-Clonic seizures, also often referred to as ‘Grand Mal’ seizures, are a particularly dangerous type of generalised seizure and a key concern for those experiencing alcohol withdrawal. They are most likely to occur around the second day of detox but remain a risk throughout the first week.

They can be identified by two distinct phases. The first ‘tonic’ phase is characterised by a stiffening of the patient’s muscles and a loss of consciousness. This can result in a sudden groan or cry as well as collapse, and the patient may also bite the inside of their mouth, producing blood.

The second ‘clonic’ phase is characterised by convulsions, a rapid and involuntary jerking of the arms and legs. As their muscles relax, the patient may also lose control of their bowels or bladder.

After one to three minutes, the patient will usually begin to regain consciousness and may be disoriented, tired and irritable.

If a seizure has a duration of more than five minutes, or if the patient experiences three or more consecutive seizures without regaining consciousness, the seizure will be classed as a medical emergency requiring urgent medical care.

What is the Kindling Effect?

The severity of alcohol withdrawal symptoms is particularly affected by how many times the individual has gone through withdrawal.

The more times an individual has detoxed and relapsed, the more likely they are to experience seizures during a detox. It is believed that undergoing the process accumulates irritation to the brain, meaning that even detoxes which might otherwise have been classed as lower-risk can be dangerous. [6]

What are the Main Risks Associated with Alcohol-Related Seizures?

Doctor discussing with client

Tonic-clonic seizures pose multiple risks to the individual, some of which can be fatal:

  • Unless they are lying down when a patient experiences a tonic-clonic seizure, they are likely to fall to the floor, risking injuries to the head and spine.
  • During the convulsions experienced during the second stage, a patient is at risk of choking on their tongue or vomiting.
  • The symptoms of a seizure can also exacerbate existing medical issues, potentially triggering more serious health complications such as a heart attack.

Can You Prevent Seizures During an Alcohol Detox?

pills

While seizures cannot be definitively ruled out, there are methods to reduce the chance of experiencing one during an alcohol detox.

Studies have shown that oral benzodiazepines are the most effective medication for preventing severe withdrawal syndrome and, in particular, avoiding seizures. [7]

It is also important to take care of your body as much as possible during alcohol detox to maintain physical health. Where possible, the individual should try their best to remain well hydrated, eat regularly, rest and relax.

How can you Help Someone Having a Seizure?

How long rehab

Due to the risks involved, individuals should never undergo an alcohol detox alone. If they do not need or cannot access inpatient care, they should be with a friend or family member who can support them and monitor their well-being.

Some key ways a person experiencing a seizure should be supported are:

  1. Keep track of how long the seizure lasts.
  2. If necessary, cushion the patient’s head and remove any nearby hazards.
  3. Once the convulsions have stopped, place the patient in the recovery position.
  4. Contact doctors or, in serious circumstances, emergency services.

How can Seizures Related to Alcohol Withdrawal be Treated?

Diagnosis

As withdrawal symptoms can vary so much between individuals, medical professionals will need to assess the risks and the specific requirements on a case-by-case basis. However, there are a whole variety of medications which can be administered to support patients.

Benzodiazepines can reduce the chance of seizures whilst also treating other symptoms, such as insomnia. Haloperidol can also be used if the patient does not respond to benzodiazepines.

Treatment for severe withdrawal may also require a hospital visit, where delirium tremens can be treated more effectively with intravenous sedatives.

Other medications may also be prescribed to assist with other withdrawal symptoms, such as naltrexone and acamprosate to reduce the risk of relapsing, beta blockers to assist with anxiety and other withdrawal, and clonidine to stabilise heart rate and blood pressure. [8]

Is Outpatient Treatment Suitable During a Detox?

Outpatient detoxes, involving frequent check-ups with a medical practitioner, can be suitable for individuals at low risk of delirium tremens and seizures.

However, if an individual is at risk of seizures, it is a much safer option to choose an environment where their physical and psychological well-being can be monitored by trained professionals with access to medication and medical equipment.

Inpatient environments can also be beneficial as a space away from potential triggers or exacerbating factors.

What Happens After an Alcohol Detox?

Two doctors in white coats and stethoscopes talking

It is important to remember that detox is only the first stage in recovering from alcohol addiction.

The main purpose is to ensure that an individual is in a sober state when they commence a treatment programme and embark upon recovery.

Therapy is an essential tool to explore and rebuild thought and behavioural patterns. Psychotherapy can be useful to explore emotion, while cognitive behavioural therapy is used to identify and alter potentially damaging thought patterns.

Holistic treatments such as meditation, acupuncture, and art therapy can also play a beneficial supporting role in battling addiction and maintaining sobriety.

Another highly beneficial treatment is the attendance of support groups, the most famous probably being AA, which offers a 12-step programme. These groups can not only provide a broad support network of people with shared experience but can contribute to feelings of empowerment over the course of recovery.

Conclusion

In summary, seizures are a frightening and dangerous aspect of alcohol withdrawal which should always be taken seriously.

Those undergoing an alcohol detox require not only support and reassurance but close monitoring and, in severe circumstances, medical intervention.

If you or someone you know need more assistance, ring our helpline on 0800 111 4108.

References

[1] https://www.ncbi.nlm.nih.gov/books/NBK482134/

[2] https://www.nhs.uk/conditions/epilepsy/#:~:text=Seizures%20are%20bursts%20of%20electrical,get%20slowly%20better%20over%20time.

[3] https://www.medlink.com/articles/alcohol-withdrawal-seizures

[4] https://onlinelibrary.wiley.com/doi/full/10.1111/add.15647

[5] https://pubmed.ncbi.nlm.nih.gov/17323538/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312739/

[7] https://pubmed.ncbi.nlm.nih.gov/17323538/

[8] https://pubmed.ncbi.nlm.nih.gov/1363375/

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