title: Alcohol and drugs in epilepsy: pathophysiology, presentation, possibilities, and prevention.
abstract: The potentially serious outcomes from ingestion of and dependence on toxins make this an important topic for epileptologists. We must be aware of the potential for harm from compounds that may be freely available, yet patients may try to conceal their use. Problematic compounds may cause seizures either acutely or on withdrawal: Their use may reduce effectiveness of antiepileptic drugs, or may simply promote and enhance chaotic lifestyles. Any or all of these factors may worsen seizure control or even directly cause seizures. This article highlights the pathophysiology behind provoked seizures, provides clues to diagnosis, and then outlines the steps that clinicians should take to reduce the deleterious effects of toxic compounds.
authors.affiliation: Institute of Neurology, Southern General Hospital, Glasgow, United Kingdom. johnpaul.leach@ggc.scot.nhs.uk
authors.forename: John Paul
authors.initials: JP
authors.lastname: Leach
authors.forename: Rajiv
authors.initials: R
authors.lastname: Mohanraj
authors.forename: William
authors.initials: W
authors.lastname: Borland
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D020270:Alcohol Withdrawal Seizures / Q000503:physiopathology / Q000517:prevention & control; D000437:Alcoholism / Q000150:complications* / Q000503:physiopathology; D019969:Amphetamine-Related Disorders / Q000150:complications; D001569:Benzodiazepines / Q000009:adverse effects; D002492:Central Nervous System Depressants / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications; D004827:Epilepsy / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D000431:Ethanol / Q000009:adverse effects*; D006556:Heroin Dependence / Q000150:complications; D006801:Humans; D007649:Ketamine / Q000009:adverse effects; D002189:Marijuana Abuse / Q000150:complications; D012640:Seizures / Q000139:chemically induced / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000150:complications* / Q000503:physiopathology; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects
chemical_list: D002492:Central Nervous System Depressants; D001569:Benzodiazepines; D000431:Ethanol; D005680:gamma-Aminobutyric Acid; D007649:Ketamine