During the detoxification process, primary and secondary preventative measures can be taken. Prompt treatment of alcohol withdrawal seizures is recommended to prevent status epilepticus. Alcohol abuse is a major precipitant of status epilepticus (9-25% of cases), which may even be the first-ever seizure type. Other seizures in alcohol-dependent individuals may be due to concurrent metabolic, toxic, infectious, traumatic, neoplastic and cerebrovascular diseases and are frequently partial-onset seizures. However, a genetic predisposition to alcohol withdrawal seizures is possible. Although the relationship of seizures to alcohol use is likely to be dose dependent and causal, the available clinical data do not suggest that alcohol use results in seizure genesis. During prolonged intoxication, the CNS adapts to the effects of alcohol, resulting in tolerance however, these adaptive effects seem to be transient, disappearing after alcohol intake is stopped. These include effects on calcium and chloride flux through the ion-gated glutamate NMDA and GABA receptors. Alcohol acts on the brain through several mechanisms that influence seizure threshold. As a result, during withdrawal from alcohol, usually 6-48 hours after the cessation of drinking, seizures may occur. The seizure threshold is raised by alcohol drinking and declines on cessation of drinking.

The prevalence of epilepsy in alcohol-dependent patients of western industrialised countries may be at least triple that in the general population, whereas the prevalence of alcoholism is only slightly higher in patients with epilepsy than in the general population. The relationship between alcohol and seizures is complex and multifaceted.

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