만성 알코올 중독환자에서의 경련
Seizures in Chronic Alcoholics
류상효, 송홍기, 이주헌, 박환석, 남경식,
소속 상세정보
류상효 ( Ryu Sang-Hyo )
한림대학교 의과대학 신경과학교실
송홍기 ( Song Hong-Ki )
한림대학교 의과대학 신경과학교실
이주헌 ( Lee Ju-Hun )
한림대학교 의과대학 신경과학교실
박환석 ( Park Hwan-Suk )
한림대학교 의과대학 신경과학교실
남경식 ( Nam Kyeong-Sick )
한림대학교 의과대학 신경과학교실
KMID : 0877220030070010041
Abstract
Purpose：Seizures constitute one of the most frequent medical complications in alcoholics. The purpose of this study is to elucidate clinical characteristics of seizures in chronic alcoholics.
Methods：Subjects were 50 alcoholics with seizure who were admitted to Kang-Dong Sacred Heart Hospital between Jan. 1999 to May. 2002. We classified them into alcohol withdrawal seizure (AWS) and alcohol related seizure (ARS). AWS was defined as 1) seizures occur within 72 hrs after the last alcohol intake and 2) occurring in the patients without focal abnormalities on brain CT and EEG. ARS was defined as 1) seizures occurring more than 72 hrs after the last alcohol intake, 2) occurring regardless of onset-time in the patients who had concomitant focal brain lesions or focal abnormalities on EEG, and 3) occurr in patients who had experienced seizure unrelated with alcohol. Their clinical, electrophysiologic and neuroradiologic features were analyzed.
Results：45 patients (90%) were male. Mean age was 47 years. 48 patients (96%) were presented with generalized tonic-clonic seizure. 28 patients (56%) were classified into AWS and 22 (44%) into ARS. Mean age was 46 years in patients with AWS and 54.9 in ARS (p=0.04). Mean duration of alcohol intake was 17 years in AWS and 26.2 in ARS (p=0.002). Mean amount of alcohol intake (yrs x bottles/day) were 30.3 in AWS and 42.0 in ARS (p=0.061). EEG showed diffuse slowing in 5 of AWS, sharp waves in 4 of ARS, focal slowing in 3 of ARS and PLEDs in one of ARS. Among 28 patients with AWS, only one patient was treated with long term antiepileptic drugs (AED). Among 22 ARS, 14 (64%) patients were treated with long term AED. One patient of each group experienced recurrent seizure during follow up. Delirium tremens was developed in 17 patients (34%). Among them, 13 (76%) had alcoholic liver disease (p=0.036).
Conclusions：Our study suggests that patients with ARS were older and drunk more for a longer period of time than patients with AWS. Long term AED administration may be required to prevent recurrent seizures in patients with ARS. On the other hand, delirium tremens may be significantly associated with alcoholic liver disease.
키워드
Alcohol withdrawal seizure;Alcohol related sei-zure;Delirium tremens
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