The findings of a study at Southern Illinois University suggest that alcohol withdrawal in people with epilepsy (i.e. the alcohol-free period that follows a prolonged period of regular/heavy drinking) increases the risk of death following a seizure. This could be caused by respiratory compromise and longer seizure duration, which are both recognised risk factors for sudden unexpected death in epilepsy (SUDEP). Efforts to prevent excessive drinking in people with epilepsy should, therefore, form part of the strategy to reduce SUDEP risk.According to the authors of the study, which is published in the scientific journal Epilepsy and Behavior, people with epilepsy who drink heavily/excessively should be carefully monitored during withdrawal periods, when they are particularly susceptible to seizures.For the investigation, researchers led by Dr Carl Faingold evaluated the effects of ethanol (alcohol) withdrawal in a genetic rodent model of epilepsy. They subjected the rodents a four-day ‘binge’ ethanol treatment, and then induced epileptic seizures in them 18-24 hours after the last ethanol dose (i.e. during alcohol withdrawal). The team then assessed the animals’ breathing patterns, how long they were confused for after a seizure and how many of them suffered seizure-induced death.They compared the findings with those from two other animal groups, which they also included in the study. One contained the same epilepsy models that were in the original group, but these received a non-alcoholic treatment instead of ethanol, and the other contained healthy (non-epileptic) rodents who received ethanol treatment. Aside from these differences, all procedures and assessments undergone by the animals were the same.The scientists found that, following seizures, all of the epilepsy models showed a loss of the ‘righting reflex’ (which allows the body to gain an upright position following a fall) and respiratory distress. These signs were not seen in the healthy animals.They also observed that epilepsy models subjected to ethanol withdrawal showed a significant increase in both the duration of confusion following a seizure, and respiratory distress, compared to those that did not receive ethanol.Finally, the researchers found that significantly more of the epilepsy models subjected to ethanol withdrawal experienced seizure-induced death than either the epilepsy models not treated with ethanol or the healthy animals.They conclude that ethanol withdrawal causes a significant increases in the duration of confusion following a seizure as well, as respiratory distress, which contributes to the greater incidence of mortality in rodents that are genetically prone to epilepsy.In this experiment, the team in Illinois aimed to create a state of alcohol withdrawal that was as close as possible to the human condition. Their results suggest that alcohol consumption is something that should be specifically discussed by people with epilepsy and their doctors.Author: Dr Özge ÖzkayaClick here to read more stories about living with epilepsy.