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Alcohol and Illicit Drug Abuse Associated with Epileptic Seizures

Introduction

Patients sometimes present to the emergency department with seizures related to excessive alcohol use or illicit drug use. These seizures are usually acute symptomatic seizures resulting from substance withdrawal, direct toxic effects of the abused substance on the brain, or from indirect mechanisms, such as head trauma resulting from alcohol or substance abuse. This chapter reviews the mechanisms, clinical manifestations, and principles of management of alcohol-related seizures (ARS) and seizures related to drug abuse.

Alcohol Abuse and Dependence

The Diagnostic and Statistical Manual-IV (DSM-IV) defines alcohol abuse as a maladaptive pattern of alcohol use leading to clinically significant impairment or distress, as manifested by one or more of the following, occurring within a 12-month period:
  1. Recurrent alcohol use resulting in failure to fulfill major role obligations at work, school, or