Abstract Details

Title Emergency Department Treatment of Alcohol-associated Seizures in Detroit: A Multicenter Retrospective Study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S24 - Epilepsy Clinical Syndromes and Management (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Background Studying AAS in the ED is essential due to the significant disease burden they impose, helping healthcare providers better understand and manage these cases.

Objective Analyze the emergency department (ED) management of alcohol-associated seizures (AAS).

Design/Methods A retrospective study was conducted from June 1, 2018 through December 31, 2018 on all adult ED visits at the Detroit Medical Center presenting with AAS or non-alcohol related seizures (SC). AAS was defined as seizures presenting in patients with acute withdrawal or acute intoxication. Data on demographics, diagnostic tests, epilepsy history and hospital disposition was collected. Non-seizure related encounters, refill visits, and syncope encounters were excluded.

Results Of 997 ED visits for seizures, there were 151 AAS and 833 SC encounters. Within the AAS group, 76 (50.3%) of the encounters were alcohol-induced and 73 (48.3%) were deemed secondary to alcohol withdrawal. Thirteen (8.6%) presented with status epilepticus. Patients with a previous diagnosis of epilepsy were 82.1% in the AAS group and 68.9% were prescribed anti-seizure medications (ASMs) at home. AAS encounters were more likely to receive a benzodiazepine compared to SC (p<0.05). Compared to SC, the AAS cohort had more ICU admissions (p<0.05) and 33% of ICU admissions were diagnosed with status epilepticus. AAS encounters were also less likely to be discharged home with ASMs than the SC group (p< .00001). However, those with AAS were more likely to return to the ED for seizures in the following year (p<.01).

Conclusions Alcohol-associated seizures were more likely to require admission to the ICU. Although AAS presented more often to the ED with recurrent seizures, they were less likely to receive an ASM upon discharge. Larger studies are needed to determine risk factors for recurrent alcohol-associated seizures to reduce ED visits and determine appropriate treatments, educational resources, and social support.

Authors/Disclosures
Tabassum Chowdhury PRESENTER	Ms. Chowdhury has nothing to disclose.
Melissa Ly	Miss Ly has nothing to disclose.
Jason Liu	Mr. Liu has nothing to disclose.
Shatha Wahbi	Ms. Wahbi has nothing to disclose.
Manik Tetarbe, MD (Detroit Medical Center)	Dr. Tetarbe has nothing to disclose.
Maysaa M. Basha, MD (Wayne State University, Detroit Medical Center)	Dr. Basha has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai.
Deepti Zutshi, MD, FAAN (Wayne State University School of Medicine)	Dr. Zutshi has nothing to disclose.