Service de Neurophysiologie Clinique et Epileptologie, Hôpital de la Timone, 13385 Marseille, France
While the links between alcoholism and epilepsy are well demonstrated, the classification of alcohol related seizures is still controversial. The best recognized seizures are the « alcohol withdrawal seizures” (AWS). However, experimental and clinical data strongly suggest that withdrawal is not the only mechanism by which the chronic absorption of alcohol may act. Specific epileptogenesis may underlie seizures unrelated to withdrawal (SUW). Epileptogenesis in this context involves several mechanisms including alterations of excitation/inhibition systems and a kindling-like effect. A classification scheme was proposed in which patients presenting with seizures unrelated to any cause other than alcohol are classified in several successive stages of ’alcoholic epilepsy’, the first being characterized by AWS, the second by SUW and the last by persistent chronic seizures.