Etiology and weekly occurrence of alcohol-related seizures.
OBJECTIVE
1) To determine the prevalence of identifiable causes of alcohol-related seizures other than alcohol withdrawal. 2) To test the hypothesis that patients with alcohol-related seizures present with greater frequency following Sundays when alcohol is not commercially available.


METHODS
This was a retrospective chart review of 140 consecutive patients presenting with alcohol-related seizures during a six-month period. Identifiable causes of seizures other than alcohol withdrawal and the day of the week of presentation were documented.


RESULTS
One hundred forty individual patients were eligible for study. Identifiable causes of seizures other than alcohol withdrawal were found in 53.6% of patients, and they were distributed as follows: 1) current or past history of significant head trauma 25.7%, 2) idiopathic seizure disorder 15.7%, 3) cerebrovascular accident 5.7%, 4) nontraumatic intracranical lesion 3.6%, and 5) toxic/metabolic abnormalities 2.9%. Alcohol is not available for purchase on Sundays because of the "Blue Laws" in Massachusetts. A total of 34.5% of patients with alcohol withdrawal seizures presented on Mondays (p < 0.001). Of patients with identifiable causes of seizures other than alcohol withdrawal, only 16% presented on Mondays (p > 0.10).


CONCLUSIONS
Approximately 50% of seizures in alcohol-dependent patients are potentially unrelated to alcohol withdrawal. Patients with alcohol withdrawal seizures presented with greater frequency on Mondays following the 24-hour period when alcohol was not commercially available in Boston. This suggests that patients with alcohol withdrawal seizures may present with greater frequency following periods of decreased availability of alcohol.
Rathlev
Niels K
NK
Department of Emergency Medicine, Boston Medical Center, Boston, MA 02118, USA. ntathlev@bu.edu
Ulrich
Andrew
A
Shieh
Ted C
TC
Callum
Michael G
MG
Bernstein
Edward
E
D'Onofrio
Gail
G
D000328:Adult; D020270:Alcohol Withdrawal Seizures / Q000453:epidemiology*; D001900:Boston / Q000453:epidemiology; D016009:Chi-Square Distribution; D006259:Craniocerebral Trauma / Q000150:complications*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D016347:Medical Records Systems, Computerized; D015995:Prevalence; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors