Electrolyte changes and acid base balance after alcohol withdrawal

Abstract

70 chronic alcoholics in the withdrawal state, 45 with convulsions and 25 controls without convulsive seizures, were tested with respect to electrolyte changes and acid base balance in serum or blood and cerebrospinal fluid (CSF). It was of special interest to note that there was a partial independence between magnesium levels in serum and CSF. Thus the serum level has only a limited liability as to magnesium depletion suggested to be responsible for seizure precipitation. In the seizure group a slightly but significantly lower magnesium, potassium and calcium in CSF and a significant decrease of potassium and calcium in serum were revealed. In the nonzeizure controls a similar decrease of magnesium in serum and potassium in CSF was observed while serum potassium and calcium in CSF and serum remained in low normal range. In both groups there was a prominent respiratory alkalosis. The role of magnesium depression for seizure precipitation is discussed with respect to the concomitant changes of other electrolytes and acid base disturbances.

Alcohol Withdrawal and Hypokalaemia: A Case Report

“…Laso et al (1990) also showed a close negative correlation between intensity of withdrawal and serum potassium. Meyer and Urban (1977) revealed a significant decrease of potassium in their group of alcoholics with withdrawal seizures. Serum potassium remained within the normal range (although low) in their control group (withdrawing alcoholics without seizures).…”

“…There are a number of published reports showing that serum potassium concentration falls during alcohol withdrawal, especially if complicated by delirium tremens (Meyer and Urban, 1977;Wadstein and Skude, 1978;Watson et al, 1984;Laso et al, 1990;Carl and Holzbach, 1994;Wetterling et al, 1994). Some studies even show evidence that potassium could be useful as an indicator to predict delirium tremens (Wadstein and Skude, 1978;Wetterling et al, 1994).…”

Delirium tremens and related clinical states: changes in calcium and inorganic phosphate concentrations in plasma and cerebrospinal fluid

“…In the same study phosphate was investigated in 22 patients at admission, three had a low, and three a high plasma phosphate concentration. Other investigators studied electrolytes in patients with mild or moderate alcohol withdrawal symptoms (but not DT), and in both studies cerebrospinal fluid (CSF) and plasma calcium were within normal range (8,9).…”