Abstracts

Rationale: Seizure can be associated with various provocative factors, and alcohol is one of the most important risk factors for the development of seizure in adults. Some patients with alcohol-related seizures subsequently develop delirium tremens, which is the most severe spectrum of alcohol withdrawal syndrome with high morbidity and mortality. However, there are limited studies on the clinical predictors for the development of delirium tremens in patients with alcohol-related seizure Methods: We prospectively included patients who experienced alcohol-related seizure from three tertiary hospitals between March 2013 and February 2014. In all patients, alcohol withdrawal was the only or one of the strongest provocative mechanisms for the development of seizure. We indentified clinical predictors for the subsequent development of delirium tremens by using of univariate analysis. Results: Among the 49 patients (43 male, mean age: 52.4 ± 13.2) with alcohol-related seizure, 20 patients developed delirium tremens. Lower plasma levels of serum potassium (3.74mg/dL versus 4.22mg/dL, p=0.04) and pyridoxine (3.4mg/dL versus 16.9mg/dL p=0.02) with a higher plasma level of homocysteine (24.0μmol/L versus 13.0μmol/L, p=0.002) were associated with the subsequent development of delirium tremens. We could not find out association between the development of delirium tremens and previously documented risk factors such as hypoalbuminemia and thrombocytopenia. Conclusions: We show that some easily determinable parameters may be useful to predict the development of delirium tremens in patients with alcohol-related seizure. Recruitment of more patients and multivariate analysis are necessary to accurately estimate the clinical implication of the individual risk factors.