To Study Predictors For Withdrawal Seizures In Patients Of Alcohol Withdrawal Syndrome

ABSTRACT

Introduction– The alcohol withdrawal seizure(WS) occurs during the early phase of withdrawal and is characterized by reduction in the seizure threshold and it emerges within 48 hours of cessation of prolonged drinking (Brathen G et al,1999;Victor M et al,1967.)The appearance of a withdrawal seizure represents a strong risk factor for progression into a severe withdrawal state with following development of DT in up to 30% of cases(Victor M et al,1967). Aim– The purpose of the current study is to identify the most parsimonious collection of risk factors present at the time of hospital admission that were predictive for the development of WS. METHODOLOGY– 102 subjects admitted at deaddiction centre, SMS hospital were selected using a screening performa which was followed by a comprehensive assessment of alcohol use followed by relevant laboratory investigations with blood pressure and pulse rate recording. Severity of alcohol withdrawal syndrome (AWS) was determined in analogy to the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA–Ar) scale. Patients were put on standard treatment based upon institute guidelines and withdrawal was assessed for 1 week. Patients were monitored for withdrawal seizure and diagnosis was made as per criteria of ICD 10. RESULTS– Age of onset of drinking, duration of alcohol abuse and daily ethanol intake were found to be significantly correlated to the development of WS. Systolic BP, Diastolic BP, Heart rate had significant correlation to the occurrence of WS which can be attributed to the autonomic hyperactivity during the withdrawal state. CIWA–Ar score also came out to be a significant risk factor to the development of WS.Previous history of seizures, delirium tremens, previous alcohol withdrawal syndrome and previous detoxification episodes were also a significant risk factor for the occurrence of WS . CONCLUSION– The various variables that were found to be significantly correlated to the occurrence of WS are mentioned as follows age, duration of abuse, daily alcohol intake, CIWA–Ar score>15, systolic & diastolic BP, previous history of WS and DT, previous history of alcohol withdrawal syndrome and previous detoxification episodes.