What are the features of alcohol withdrawal seizures?

Updated: Oct 18, 2020
  • Author: Nathanael J McKeown, DO; Chief Editor: David Vearrier, MD, MPH  more...
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Answer

Approximately 23-33% of patients with significant alcohol withdrawal have alcohol withdrawal seizures ("rum fits"). Features of these seizures are as follows:

  • Seizures are usually brief, generalized, tonic-clonic in nature, and without an aura. They occur in a cluster of  one to three seizures with a short postictal period. Partial seizures are not uncommon. In 30-50% of patients, the seizures progress to DT.

  • The incidence peaks 24 hours after the most recent alcohol ingestion.

  • Seizures typically terminate spontaneously or are easily controlled with benzodiazepines.

  • Status epilepticus may occur in 3% of alcohol withdrawal seizures and should prompt an investigation for other causes, as people with alcoholism are prone to head injuries, chronic idiopathic epilepsy, and meningitis.


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