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If you moderate your alcohol intake so that you don’t suffer an epileptic seizure, then you are making good decisions regarding your health issues. As long as you continue taking your anti-epileptic drugs (AEDs) and remember that alcohol can render you more sensitive to your medication’s effects, you are more likely to be cautious about your alcohol intake.

However, if you begin to drink too much, regardless of your epilepsy and medications, you may put yourself in a dangerous position. Drinking to excess can lead to withdrawal seizures, which happen up to three days after you had your last drink.

You should also continue taking your anti-epileptic medication as prescribed, even when you want to have a drink or two. Otherwise, you may experience what’s called a break-through seizure because you don’t have medication in your bloodstream. And don’t forget, because your medications make you more susceptible to intoxication, driving isn’t a good idea, no matter how little you may have had.

What is a Seizure?

When our brain sends electric signals to the nerves in our body to do something, or receives messages about a sensation you are feeling, that is a controlled electrical impulse. When you have a seizure, the electrical impulses go way out of control—this is called an uncontrolled electric disturbance.

When this happens, your emotions and behavior can change. Your level of consciousness may also change. You may make uncontrolled movements with your limbs or, if you have a focal seizure, you may be unaware of your surroundings or what is happening near you. You may also have a fixed stare and seem to be looking at something.

A seizure can last from half-a-minute up to about two minutes. If you experience a seizure that lasts longer than five minutes, you need immediate, emergency medical care. Seizures can develop from several causes: a closed-head injury, stroke, or infection (meningitis or another disease). However, the causes of seizures are often unknown and just because you have seizures does not mean you have epilepsy.

Alcohol Withdrawal Seizures vs. Epileptic Seizures

Binge drinking can lead to seizures as either a result of alcohol poisoning or as a symptom of withdrawal, several hours (up to 72) after you took your last drink. This includes delirium tremens, another type of alcohol use-related seizure that includes possible hallucinations.

If you stop drinking large amounts of alcohol, cold turkey, you run the risk of developing withdrawal seizures; in addition, your risk of developing epilepsy increases three times as much as someone who doesn’t drink to excess. Even if you have stopped drinking after experiencing alcohol-related seizures, you may continue to have seizures whether you drink or not.

Types of Seizures

Not every seizure is the same, nor do they all start for the same reasons. Some develop from epilepsy, while others are caused by brain tumors or blood vessel diseases within the brain.

  • Partial (focal)

    There are two types of partial, or focal, seizures. These are the simple focal seizure, which doesn’t impact memory or awareness and the complex seizure, which affects your memory and awareness of events before the seizure starts, during the seizure, and right after it ends. It may also affect your behavior. You’ll experience abnormal muscle contractions and your eyes move from side to side, out of your control. You may feel numb or tingly, you may feel nauseated and sweat, you may experience abnormal discomfort or pain, your heart will beat rapidly, and your pupils will dilated.

  • Generalized Seizures

    These seizures have several sub-types

    • Generalized tonic-clonic (grand mal) seizures
      This is the most common type. Your limbs stiffen, then jerk (the tonic, then clonic phases). Your breathing may slow down or stop totally. During the jerking phase of your seizure, your breathing may return but be irregular. You may also become incontinent (lose bladder or bowel control) and bite your tongue. After the seizure, you may be confused and lethargic, have a headache, and want to sleep. It may take several minutes or hours to fully recover.
    • Myoclonic Seizures
      These are fast and brief contractions of your muscles, taking place on both sides of your body at the same time. At times, only one limb or foot may be involved. Because they only look like clumsiness or a sudden jerk, you may not think anything is wrong. (If someone’s foot jerks while they are sleeping, this is not epilepsy.) You shouldn’t need first aid, but if this is your first seizure you should have a full medical evaluation.
    • Atonic Seizures
      You unexpectedly lose your muscle tone. Descriptive names include drop attacks, akinetic, or astatic seizures. When others see you having this type of seizure, they see you lose your normal posture or your head dropping. Because these seizures come out of the blue, you may fall hard, experiencing facial or head injuries. Children and adults should wear protective helmets if they have this form of seizure, because they generally do not respond well to drug therapy.

How Does Alcohol Interact with a Diagnosis of Seizures or Epilepsy?

If you decide to have one or two drinks, this shouldn’t lead to more seizures for you. As long as you are taking your AEDs exactly as prescribed, having a small amount of alcohol shouldn’t affect your condition. The main side effect is that you’re likely to feel the effects of your drinks more quickly. If you are unusually sensitive to either alcohol or your AEDs, then you may find that drinking alcohol after taking your medication makes you drunker faster.

However, that does not mean that you can have as much alcohol as you want when taking seizure/epilepsy medication. Alcohol can have several negative effects, depending on the AED you take. It can reduce the medication’s effectiveness, severely slow down your central nervous system, or alter your blood serum levels.

Additionally, if you are an active alcoholic, you should understand that this has been linked to developing epilepsy. If you binge drink, and then stop drinking suddenly, you may go into status epilepticus, which is a medical emergency. This happens when one seizure lasts more than five minutes or when you have several seizures, one right after the other. Because of how quickly the seizures hit you, you don’t have time to recover in between, which can be potentially life-threatening. If you suffer the convulsive status epilepticus, you need emergency treatment in a hospital so that you can receive treatment.

Can Seizures be Triggered by Alcohol?

Whether you’ve ever suffered from seizures or not, you should know that, under certain circumstances, you can develop seizures after consuming alcohol in large amounts. You are highly unlikely to experience seizures from drinking small amounts of alcohol.

Similarly, if you have been diagnosed with epilepsy, having a small amount of alcohol with your AEDs in your bloodstream shouldn’t have a negative effect on your seizure activity. To get an idea of what a small amount of alcohol is, this is one or two small drinks. If you drink more than this, your seizure risk increases tremendously.

Your doctor should have warned you to avoid binge drinking or the abuse of alcohol if you have epilepsy or otherwise suffer from seizures. If you already suspect you have an alcohol use problem, discuss this with your doctor. Because of your epilepsy, you’ll need to be more careful than anyone else as you try to stop drinking. If you drink to excess and you have epilepsy, you are at risk of experiencing more seizures. Too much alcohol affects the activity level of the nerve cells in your brain, which can instigate abnormal brain activity, leading to seizures. If you spend several nights partying, this can trigger epileptic seizures as well. You need to cultivate healthy sleep patterns and alcohol does not help this process.

In fact, you may have to go into a detox facility to help you withdraw under medications that make it easier for you to stop drinking without experiencing seizures. To understand how you can alcohol can create a dangerous increase in seizures, you need to know how alcohol affects the way neurotransmitters in your brain work. Alcohol binds to special brain receptors. These are the gamma-aminobutyric acid (GABA) receptors. If you have too much GABA, you will be fatigued, slow, and slur your words. When you have too little GABA, these neurons will be too active, making you tense and anxious and increasing the risk of seizures. Even mild alcohol withdrawal can reduce the amount of GABA in the brain significantly, creating a dangerous situation for those who are at risk of seizures.

Once you stop drinking, you may also be one of a small percentage of people who develop a severe alcohol withdrawal called delirium tremens (DTs). Your nervous and mental systems undergo severe changes leading to tremors, hallucinations, and other symptoms. Untreated, or without ongoing medical supervision, this can be incredibly dangerous. If you have the DTs, you may also experience tonic-clonic seizures.

Symptoms can develop 48 to 96 hours after your last drink—this is a late stage of alcohol withdrawal. You feel fatigued and disoriented, you may also experience excitement, fear, rapid mood changes, and sensitivity to touch, sound, and light. Your heart rate changes, and you may develop seizures. You may also feel panicked or severely agitated. The changes to your heart rate or breathing can be fatal. The DTs require treatment in the hospital.

You may have heard of alcohol shakes or tremors. These are different from DT, developing soon after you stop drinking and lasting for a few hours to a couple days after a heavy drinking session. You can’t stop the shakes—they are involuntary, developing in one or more areas of your body. They aren’t dangerous, but may make it hard to do what you need to do to function.

How to Manage Epilepsy When Drinking

Once you begin taking prescribed AEDs, you won’t be able to imbibe the same amount of alcohol you did before. Your medications will make you more sensitive to the effects of alcohol, which will require you to moderate your use of alcohol. Alcohol can affect how your AED medications work in your bloodstream. It may lessen their effects or make them stronger. Don’t stop taking your AEDs when you drink.

If you tend to drink a lot of alcohol, you should avoid stopping suddenly or going cold turkey, even if you need to start a new epilepsy medication. If you do stop suddenly, you’re likely to develop alcohol withdrawal symptoms and seizures. Talk to your doctor about how to mitigate the symptoms and onset of withdrawal when you make an effort to quit or moderate your drinking.

Sources:

  • https://www.health.harvard.edu/blog/new-high-blood-pressure-guidelines-2017111712756

  • https://www.rush.edu/health-wellness/discover-health/6-high-blood-pressure-facts

  • https://www.cdc.gov/bloodpressure/index.htm

  • https://kcms-prod-mcorg.mayo.edu/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc-20373417