Epileptic with unpredictable seizures after drinking

Resolved question:
A friend of mine has had epilepsy for over 10 years. She knows the best thing to do is not to drink alcohol but that is a challenge for her. Some nights she will go out and drink and excessive amount and the next day have a seizure. But then some nights she will go out and drink the same excessive amount and nothing happens the next day. She takes Lamictal XR 200 mg x2 a day. Why is that?

Submitted: 4 Days
Category: Family Physician-GP

Expert:  Dr. Sudhir Kumar replied 4 Days.

A copy of the response by Doctor to your query.

Hello,

Thank you for asking your query at DoctorSpring.

Since your friend is having epilepsy (I assume probably on treatment), this particular episode of seizures is probably by a trigger. This trigger can be the alcohol intake, the exhaustion or even deprivation of sleep.

Now in an epilepsy patient it is very important to avoid any kind of trigger. Repeated seizures can result in brain damage and other problems, so all care has to be take to avoid precipitants of seizure. Benzodiazepines are used in alcohol withdrawal seizure.

At this point I hope you would understand that your friend was not having an alcohol withdrawal seizure. Being a known epipleptic patient this was a seizure caused by a trigger. The online materials you might have come across is probably withdrawal seizure, which is not applicable in this case.

The good number of drinks is whatever number which does not result in seizure. Unfortunately it can be zero also ! I would strongly recommend to cut down any binge drinking. Also make sure, in case there consumption does happen your friend gets adequate rest and hydration.

Hope this helps
Please feel free to ask followup questions via email itself.

Thank you
DR. SUDHIR KUMAR , MD (INTERNAL MEDICINE) DM (NEUROLOGY)

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