Alcohol withdrawal seizures: Difference between revisions
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==Background== | ==Background== | ||
*Onset after last drink: 6-48h | |||
*Multiple seizures: 60% of pts | |||
*Progression to DTs: 33% of pts | |||
*May occur in spectrum or independent of [[Alcohol withdrawal]] syndrome | |||
*Treat with [[Benzodiazepines|benzos]] (not phenytoin) | |||
==Clinical Features== | ==Clinical Features== | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Seizure DDX}} | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 17:22, 15 February 2016
Background
- Onset after last drink: 6-48h
- Multiple seizures: 60% of pts
- Progression to DTs: 33% of pts
- May occur in spectrum or independent of Alcohol withdrawal syndrome
- Treat with benzos (not phenytoin)
Clinical Features
Differential Diagnosis
Seizure
- Epileptic seizure
- First-time seizure
- Seizure with known seizure disorder
- Status epilepticus
- Temporal lobe epilepsy
- Non-compliance with anti-epileptic medications
- Hyponatremia
- INH toxicity
- Non-epileptic seizure
- Meningitis
- Encephalitis
- Brain abscess
- Intracranial hemorrhage
- Alcohol withdrawal
- Benzodiazepine withdrawal
- Barbiturate withdrawal
- Baclofen withdrawal
- Metabolic abnormalities: hyponatremia, hypernatremia, hypocalcemia, hypomagnesemia, hypoglycemia, hyperglycemia, hepatic failure, uremia
- Eclampsia
- Neurocysticercosis
- Posterior reversible encephalopathy syndrome
- Impact seizure (head trauma)
- Acute hydrocephalus
- Arteriovenous malformation
- Seizure with VP shunt
- Toxic ingestion (amphetamines, anticholinergics, cocaine, INH, organophosphates, TCA, salicylates, lithium, phenothiazines, bupropion, camphor, clozapine, cyclosporine, fluoroquinolones, imipenem, lead, lidocaine, metronidazole, synthetic cannabinoids, theophylline, Starfruit)
- Psychogenic nonepileptic seizure (pseudoseizure)
- Intracranial mass
- Syncope
- Hyperventilation syndrome
- Migraine headache
- Movement disorders
- Narcolepsy/cataplexy
- Post-hypoxic myoclonus (Status myoclonicus)