Convulsions in Nonepileptic Patients on Withdrawal of Barbiturates, Alcohol and Other Drugs

Kalinowsky, Lothar B.

doi:10.1001/archneurpsyc.1942.02290120098006

Cited by 53 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patient 19 had only one GTC seizure during the entire observation period, and patient 21 had a maximum of 3 in withdrawal week 2 , whereas 2 GTC seizures occurred during baseline. One patient (16) had GTC seizure status epilepticus 10 davs after PB levels were undetectable which re- sponded to PHT (Fig 2). The patient had experienced increased CPS when PB was in the 17 to 14 mg4 range.…”

Section: Resultsmentioning

confidence: 89%

See 1 more Smart Citation

Seizures during barbiturate withdrawal: Relation to blood level

Theodore

Porter

Raubertas

1987

Annals of Neurology

View full text Add to dashboard Cite

We studied 21 patients with complex partial seizures during phenobarbital (PB) or primidone withdrawal. Blood levels were measured daily, and seizure frequency was monitored by nursing staff and EEG-video telemetry. Patients were monitored for one week of baseline and for five weeks after PB tapering was initiated (withdrawal). Most were observed for at least one week after levels were undetectable. When ranked seizure counts were averaged, there was a tendency for seizure rates to be highest as PB levels passed through the range 15 to 20 mg/l, compared with rates at higher or lower PB levels. There was little or no relation between the rate of PB withdrawal, other drug therapy, or initial PB level and the ratio of highest seizure frequency to mean seizure frequency. Patients withdrawing from PB may be most likely to experience an increase in seizure frequency when their PB blood level falls below 20 mg/l.

show abstract

Section: Resultsmentioning

confidence: 89%

“…tions attributed to phenobarbital (PB) withdrawal (although less common than in patients addicted to short-acting barbiturates) were reported soon after introduction of the drug [ 15, 16,28). However, few systematic studies have been performed, and the incidence and severity of PB withdrawal seizures are uncertain [12,28).…”

mentioning

confidence: 99%

Seizures during barbiturate withdrawal: Relation to blood level

Theodore

Porter

Raubertas

1987

Annals of Neurology

View full text Add to dashboard Cite

show abstract

“…Such figures obviously depend critically on the criteria for admission and the definition of alcohol withdrawal. If seizures occur after alcohol withdrawal they commonly do so at 24-48 hours (Kalinowsky, 1942;Isbell et al, 1955;Giove and Gastaut, 1965;Hillbom and Hjelm-Jager, 1984). In a study of 241 patients with alcohol withdrawal seizures, in 50 per cent the onset of seizures was between 13 and 24 hours after drinking stopped, and in 90 per cent the onset was between 7 and 48 hours (Victor and Brausch, 1967).…”

Section: Alcohol Withdrawal Seizuresmentioning

confidence: 99%

“…In Hillbom's study (1980) the incidence being 21 of 277 patients (7.6 per cent). The seizure onset usually precedes, but may occur during or even after, the delirium (Pohlisch, 1928;Kalinowsky, 1942;Thompson, 1978). In Victor and Brausch's study of 241 cases, 100 had a single seizure, 133 had repeated seizures (usually two to four) and eight developed status epilepticus.…”

Section: Alcohol Withdrawal Seizuresmentioning

confidence: 99%

See 1 more Smart Citation

Neuropsychiatric aspects of sedative drug withdrawal

Duncan

1988

Human Psychopharmacology

View full text Add to dashboard Cite

The withdrawal syndromes after discontinuance of alcohol, barbiturates, benzodiazepines and other sedative drugs, such as chloral and paraldehyde, are all similar. The severity of a withdrawal reaction is largely determined by the daily dose, the duration of administration and the rate of fall of the drug levels after withdrawal, as well as the propensity of the individual patient. The time course of a withdrawal reaction is determined by the drug's clearance. Alcohol has a half‐life of a few hours; withdrawal symptoms may develop within 6–8 hours of abstinence and convulsions in 12–48 hours. After discontinuance of short‐ or medium‐acting barbiturates (half‐life 8–40 hours) symptoms may develop in 1–3 days, followed by convulsions and delirium after 3–8 days. Symptoms and seizures may develop in the 1–10 days after withdrawal of benezodiazepines. In patients with no prior history of epilepsy the types of seizures most commonly induced by drug withdrawal are generalized convulsions, but partial seizures are not uncommon if there is a focal cerebral lesion, or a previous history of partial seizures. Paroxysmal activity and photosensitivity may occur after barbiturate withdrawal in non‐epileptics, more commonly in severe withdrawal reactions. Similar EEG changes may be seen after alcohol and benzodiazepine withdrawal, but photosensitivity does not appear to have been shown to be a feature of the benzodiazepine withdrawal syndrome.

show abstract

Chronic Barbiturate Intoxication

Fraser¹

1954

AMA Arch Intern Med

View full text Add to dashboard Cite

ISBELL and co-workers, in 1950, showed that the behavior and neurological status of five patients experimentally intoxicated with large amounts of barbiturates for 92 to 144 days resembled that of patients chronically intoxicated with alcohol. Also, convulsions and/or a delirium followed abrupt withdrawal of barbiturates from these chronically intoxicated persons. The purpose of the present communication is to extend the series of Isbell and co-workers, from 5 to 19 cases, in order that the variations in the clinical picture of barbiturate addiction, withdrawal, and recovery can be more completely delineated. In addition, a larger series would provide sufficient controls to permit evaluation of therapeutic regimens. SUBJECTS AND METHODSFive of the subjects included in this study were those used by Isbell and co-workers,1 and they have been identified in both reports by the same code numbers, SI, S2, P3, P4, and A5. Fourteen additional male volunteers in general good physical state were selected for study shortly after their admission to the U. S. Public Health Service Hospital, in Lexington, Ky. All gave histories of addiction to opiates and chronic intoxication with large amounts of bar¬ biturates, but, after the study was completed, Patients 7, 11, and 16 retracted the history of barbiturate intoxication prior to admission. None of the patients studied had personal or familial histories of epilepsy or psychoses.The patients were continuously observed in a special closed ward throughout the study. The precautions taken have been described by Isbell and co-workers.1 Since the patients were all addicted to opiates as well as being chronically intoxicated with barbiturates, it was necessary to convert their mixed addictions to a chronic intoxication with a single barbiturate. Following transfer to the special ward, secobarbital was administered orally six times daily in the highest dosage compatible with safe ambulatory management. Secobarbital was chosen as the drug to be used in these investigations because our patients seem to prefer this barbiturate to all others. Methadone was substituted for whatever opiate the patient had been using, and then it was gradually withdrawn over a period of 10 to 14 days ; thereafter, no opiates were prescribed. Administration of secobarbital was continued at the same level during and after withdrawal of methadone. The nutritional status of all patients was evaluated. All received supplements of milk and fruit juice in addition to

show abstract

Convulsions in Nonepileptic Patients on Withdrawal of Barbiturates, Alcohol and Other Drugs

Cited by 53 publications

References 20 publications

Seizures during barbiturate withdrawal: Relation to blood level

Seizures during barbiturate withdrawal: Relation to blood level

Neuropsychiatric aspects of sedative drug withdrawal

Chronic Barbiturate Intoxication

Contact Info

Product

Resources

About