Absence Seizure -
A generalised onset seizure predominantly seen in children – commonly mistaken for daydreaming and inattentiveness. Seizures involve suddenly stopping activity, staring, loss of facial expression and unresponsive. They can last from 2-20 seconds. Recovery is immediate with no memory of the event.
To take something into the body, especially gradually, e.g. the drug is quickly absorbed into the bloodstream; the cream is absorbed through the skin.
Refrain or withhold from doing or enjoying something
Technically, a word that is formed by combining some or all parts (usually the first letters) of some of the terms. For example As Soon As Possible = ASAP
Ancient Chinese medical treatment that involves inserting fine needles and stimulating specific regions of the body for therapeutic purposes.
Having a short and relatively severe course of symptoms with a sudden onset.
Adversive Seizures -
Rotation of the eyes, head or body during a seizure.
The cause of the disease or disorder. Also spelt etiology (US).
The absence of fever, normal body temperature.
The absence or failure of formation of an organ or body part.
make worse or more serious.
Aicardi syndrome -
Is a rare genetic disorder characterised by partial or complete absence of the connection between the two hemispheres of the brain, the corpus callosum. Affects females and the onset is generally between ages 3-5 months with seizures called infantile spasms. Symptoms include seizures, profound learning disabilities and brain abnormalities such as smaller than average brain and cavities or gaps in the brain.
Alternative therapies -
Any treatment or preventative health measure other than conventional medicine.
Loss of memory. Total or partial inability to recall past experiences.
See antiepileptic drugs (AED’s)
Antiepileptic drugs -
See antiseizure medication, ASM. Also called anticonvulsants, antiepileptic medication and AED's.
Antiseizure medication -
Medications used to manage seizures. Some of these medications can be used to treat other conditions. Also called anticonvulsants, antiepileptic medication and antiepileptic drugs.
Feelings of tension, worried thoughts and physical changes like sweating and increased heart rate.
A total or partial loss of speech and language skills to express oneself or understand others. This can occur during or after seizures of dominant hemisphere (usually the left side of the brain).
Interruption or absence of spontaneous breathing.
Is the use of pure aromatic oils in the complementary management of disease or maintenance of a healthy lifestyle. It can be either diluted and massaged into the skin or heated in an oil burner. These oils are a mixture of plant chemicals, many which do have pharmacological effects.
When someone is examined to find out something about them, e.g. doctors check to determine any findings that can lead to a medical diagnosis.
not identical or the same on both sides.
Poor coordination – an inability to coordinate muscle activity during voluntary movement.
without tone, limp
Atonic seizure -
A generalised onset seizure where muscle tone is suddenly lost and the person slumps to the floor or if sitting, it may cause a sudden head nod. They can be difficult to control and can cause head and facial injuries. Also known as drop attacks.
Refers to a general state of arousal, selection, concentration, alertness and processing.
Not typical or usual. Different.
People use this term to describe the feeling they get before a seizure, like a warning it is going to happen, but this is actually a focal aware seizure. They can occur in isolation and include feelings such as: strange smells, visual disturbances, numbness, tingling, blushing, nausea, different emotions or feelings of déjà vu.
Purposeless, often repetitive movements that accompany a focal seizure. These include lip smacking, chewing, picking at clothes, pill rolling, mumbling or wandering in a confused state.
Examination to discover a cause of death.
the state or condition of being aware; having knowledge; consciousness
Is a part of nerve cell (neuron). Impulses travel along the axon and its main function is part of the process of communication between neurons.
Family of medications with a sedative effect, occasionally used in epilepsy to prevent seizures. Adverse side effects and reactions make this a less preferable medication choice for epilepsy.
A word frequently used to indicate that a disease process is mild or non-malignant. It usually indicates a favourable outcome.
Benign Focal Epilepsy of Childhood -
An epilepsy syndrome seen in children. Characterised by focal aware seizures during sleep with sensation changes around the face and tongue, gurgling noises may be heard by the parents and focal jerking of facial muscles is often seen. They sometimes progress into a tonic clonic seizure. Seizures are usually infrequent. The condition is usually outgrown during puberty. Also called benign childhood epilepsy with centrotemporal spikes or benign rolandic epilepsy.
Family of sedative medications which can be used as anticonvulsants or for seizure emergencies such as status epilepticus or seizure clusters. The sedative effect and tolerance limit their usefulness in long term therapy.
on both sides
Relating to living organisms, toxins or disease.
The blood circulating through the body
Is situated at the base of the brain and connects the brain with the spinal cord. It controls many functions including breathing and heart-rate, reflexes and level of alertness.
A chemical compound of the cannabis plant
Commonly known as Tegretol or Teril. It is an antiepileptic drug and can also be used for nerve pain.
Catamenial epilepsy -
When seizures in women occur in association with menstruation.
A brief attack of sudden weakness which can cause falling or head nodding. It is often triggered by an emotional response and is associated with a sleep disorder called narcolepsy.
Refers to the largest part of the brain – it is divided into two hemispheres and four main lobes. The right side controls what happens on the left side of the body and vice versa.
One of 46 bodies in the nucleus of all body cells that is the bearer of genes.
Chronic epilepsy -
When seizures are medication resistant and seizure control is not obtained.
chronic health condition -
A long lasting health condition that usually can be controlled and not cured
A condition, fact or event that affects a situation
Also known as Frisium, is sometimes used in the treatment of epilepsy. It is also used as an anti-anxiety medication.
Also known as Rivotril or Paxam. It can be used in the management of epilepsy, but has a sedative effect and people develop a tolerance. It is sometimes used in the management of seizure emergencies.
Clonic seizure -
Rhythmic jerking of part of the body or both sides of the body.
a number of seizures happening in close succession
Mental activities associated with thinking, learning and memory.
the mental processes associated with learning such as thinking, memory, concentration, reasoning and judgement.
Two or more individuals or groups working together.
Having two or more unrelated diseases.
To counterbalance or reduce the effects of the loss of function or performance.
Complex partial seizure -
See focal seizure.
The physical and mental state of the body or one of its parts, e.g. he has a heart condition; he had a medical condition.
An older term used for a tonic-clonic seizure
Corpus Callosum -
The major structure of nerve fibres connecting the two hemispheres of the brain.
The outer surface of the brain – the grey matter.
CT or CAT Scan -
Computerised Axial Tomography. Uses x-rays and computer analysis to produce images of the brain for diagnostic uses.
De’ja’ vu -
A feeling that you have already experienced the present situation
A persistent feeling of sadness and loss of interest.
Judgement based on clinical signs and symptoms leading to identification of a known health condition or disease.
A medication also known as Valium which can used in managing seizure emergencies. It is also used as a sedative, muscle relaxant and anti-anxiety agent. It is not considered for long term use because of its sedative and tolerance effects.
Revealing private or previously unknown information to another person or third party.
Deoxyribonucleic acid. The molecule that encodes genetic information in the nucleus of cells. It determines the structure, function and behaviour of the cell.
Drop Attacks -
sudden fall without warning or loss of consciousness. When these drop attacks are epilepsy, they are tonic or atonic seizures.
Abnormal or impaired function. Not working properly
Difficulty with speech and language function. Inability to speak words which one has in mind or to think of correct words, or inability to understand spoken or written words.
Electrocardiogram. A record of the electrical activity (function) of the heart. Often done in conjunction with an EEG.
Electroencephalogram. A diagnostic test that records the electrical activity (function) of the brain.
Inflammation of the brain.
Endocannabinoid system -
is a group of cannabinoid receptors located in the brain and throughout the nervous systems, and is involved in a variety of bodily processes including appetite, pain-sensation, mood, and memory, and in mediating the psychoactive effects of cannabis.
Epilepsia Partialis Continua. A form of epilepsy in which there is repetitive motor seizures (jerking, twitching) involving one small area or all of one side of the body. Consciousness is maintained. It can be treatment resistant. These seizures can also be associated with Rasmussen’s Encephalitis.
The study of the distribution and causes of health-related states or events in particular populations.
A disease of the brain that is characterised by a tendency to have recurrent, usually unprovoked seizures. The seizures are a result of sudden abnormal electrical activity in the brain. The type of seizure will depend on where it starts and spreads within the brain.
Epilepsy Syndrome -
Is characterised by a cluster of signs and symptoms customarily occurring together often with an known prognosis. One syndrome can evolve into another.
A neurologist with a special interest in epilepsy.
See Sodium Valproate.
Also known as Zarontin. This antiepileptic drug is used effectively to treat absence seizures.
the straightening (unbending) movement of a limb.
Febrile Seizures -
Also known as Febrile Convulsions. These are seizures that occur in children associated with a fever. They can occur between the ages of 6 months to 6 years and may recur if the child has a fever at other times. They are not epilepsy
Felbamate is an antiepileptic drug but is associated with a high rate of serious side effects and used only as a last resort. It has proven to be useful in the management of Lennox-Gastaut Syndrome.
bending of a joint or limb
Fluid retention -
Also known as water retention or oedema and occurs when fluid isn’t adequately removed from body tissues. Hands feet and ankles may swell or swelling can occur throughout the body.
Pertaining to one region or area (of the brain).
Focal aware seizure -
a focal seizure where consciousness and awareness is not lost.
Focal seizure -
A seizure where the seizure activity starts in one (focal) area of the brain and may or may not spread to other regions of the brain.
Focal to bilateral tonic clonic seizure -
When a focal seizure spreads in the brain to become a tonic clonic seizure (formerly called secondarily generalised tonic-clonic seizure)
A local area of abnormality (in the brain), usually where seizures begin (seizure focus).
Folic Acid -
A vitamin of the B complex. It is found in whole-grain breads and cereals, liver, green vegetables, orange juice, lentils, beans, and yeast. It is recommended to be taken prior to and during early stages of pregnancy to help prevent birth defects.
Frontal Lobe Epilepsy -
When seizures originate from the frontal lobes. Seizures can often start and end abruptly, with little, if any confusion afterwards. They are likely to occur in clusters and can look quite bizarre, resulting in difficulty obtaining a diagnosis.
Gaba aminobutyric acid, an important amino acid, functions as the principle inhibitory neurotransmitter in the brain. This helps control the nerve cells from firing too fast, which can cause seizures. The action of GABA decreases epileptic seizures and muscle spasms.
Antiepileptic drug also known as Neurontin, Pendine or Gantin. It is primarily used for focal seizures (and nerve pain).
Generalised onset seizures -
When seizure activity is seen in both hemispheres from the outset. Generalised onset seizures can be convulsive or non-convulsive, for example tonic-clonic or absence seizures.
Contains information that codes individuals genetic makeup and is passed on from generation to generation.
Related to genes or hereditary. Not all genetic disorders are inherited though.
A type of tumour found in the central nervous system (brain or spinal cord).
Major fast excitatory neurotransmitter in the central nervous system (brain and spinal cord).
as in cerebral hemisphere, is one half of the brain
Hippocampal Sclerosis -
Scar tissue or hardening of the inner aspect of temporal lobe (hippocampus). It is a common cause of focal seizures (temporal lobe epilepsy).
Situated on the inner aspect of the temporal lobe, the hippocampus is important for learning, memory and language.
Lack of oxygen (below normal levels) to the tissues and organs, including the brain.
Ictal (Ictus) -
A seizure or during a seizure.
Disease of unknown cause.
see individual education plan
The International League Against Epilepsy (ILAE) is the world’s pre-eminent association of physicians and other health professionals working in the field of epilepsy.
the state of being diminished, weakened, or damaged, especially mentally or physically
Freedom from the control of others. To make your own decisions. To carry out tasks without assistance.
Individual Education Plan (IEP) -
is a plan or programme designed for children with additional educational needs to help them to get the most out of their schooling. An IEP builds on the curriculum and sets out the strategies being used to meet that child’s specific needs.
Infantile Spasms (West Syndrome) -
Brief muscle spasms seen in infants characterised by head nodding or sudden lurching forward and are associated with developmental delay.
To hold back, control or prevent (seizures)
Inability to fall asleep or stay asleep.
Intellectual disability -
Refers to limitations in intellectual functioning such as difficulties in learning and performing daily life skills. It is evident before the age of 18 years and IQ is below 70.
Intellectual impairment -
see intellectual disability.
In pharmacology – The effect of two or more drugs acting on each other.
The periods between seizures.
Difficult to alleviate, resolve or cure. With epilepsy, intractable seizures are difficult to control seizures. Sometimes called medication-resistant or drug-resistant epilepsy.
Intractable Seizures -
Epilepsy not controlled despite adequate medication.
Isolated Seizures -
A single seizure, usually a tonic-clonic seizure, with no risk factors for epilepsy and a normal neurological examination. Does no warrant long term treatment.
Jacksonian Seizure -
A focal motor seizure (involving muscles) starting in one part of the body then progressing to other parts of the body on the same side. Seizures of this type typically cause no change in awareness or alertness.
JAE Juvenile Absence Epilepsy -
A form of absence epilepsy with onset around puberty. Characterised by absence seizures, generalised tonic-clonic seizures and sometimes myoclonic jerks.
JME Juvenile Myoclonic Epilepsy -
This is a common form of epilepsy typically beginning in adolescence. It is characterised by myoclonic jerks upon awakening, and sometimes can progress into generalised tonic-clonic seizures.
Ketogenic Diet -
This is a high fat, low carbohydrate diet used to treat seizures mostly in children. The diet is based on ketosis, a change in the body’s metabolic state in which the body burns primarily fat, not sugar, for energy. Calories and liquid intake are strictly limited and, to work, the diet must be carefully and individually calculated and rigidly controlled.
is when the body does not have enough glucose for energy, it burns stored fats instead; this results in a build-up of acids called ketones within the body.
Lamotrigine (Lamictal) -
Also known as Lamictal. Is an antiepileptic medication used for the treatment of focal and generalised seizures.
Landau-Kleffner Syndrome -
Also called Acquired Epileptic Aphasia is a rare childhood disorder in which there are speech problems associated with seizures and severe EEG abnormalities. It is more common in boys and usually between the ages of 4 and 7 years.
Lennox-Gastaut Syndrome (LGS) -
Usually begins in preschool aged children. Many seizure types are associated with LGS and 90% will have an intellectual disability. The seizures are often difficult to control.
A substance used to treat disease, injury or pain.
Inflammation of the membranes of the brain and spinal cord caused by a bacteria or virus.
Also known as Hypnovel. It is a short acting medication (benzodiazepine) used in the management of seizure emergencies outside the hospital setting. It is also a sedative used in minor procedures.
Taking only one medication.
refers to motion or movement
Magnetic Resonance Imaging. This imaging technique creates detailed pictures of the inside of the body and the brain without the use of xrays. It is used for diagnosis and can help to identify particular structures of the brain and detect abnormalities.
Myoclonic jerks -
brief shock-like jerks of a muscle or group of muscles.
Myoclonic seizures -
These are generalised onset seizures characterised by sudden, brief, muscle contractions. Often involving the muscles of the upper body, but can involve lower body or all groups of muscles.
A sleep disorder characterised by sudden and uncontrollable attacks of sleep, cataplexy, sleep paralysis and hallucinations when going off or waking up from sleep.
Neonatal seizures -
Seizures occurring in the first month of life.
Negotiated Education Plan
Neural migration defects -
Epilepsy is often associated with defects that occur during brain development when the cells are migrating out to the cerebral cortex.
Neural tube defects -
Defects that occur during development of the brain and spinal cord such as spina bifida.
Production of pictures of the brain and/or spinal cord. It can include computerised tomography ( CT) scanning, Magnetic Resonance Imaging (MRI), Photon Emission Computerised Tomography (SPECT) and Positron Emission Tomography ( PET).
Anything to do with the nervous system. Broadly the brain, spinal cord, nerves and muscles.
A specialist in the diagnosis and treatment of neurological disorders, including epilepsy. Paediatric Neurologists see children.
The nerve cells of the brain and nervous system.
The brain's ability to change and reorganise itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.
A psychologist with expertise in the field of the relationship between the brain and behaviour. Test and assessment techniques are used to diagnose specific cognitive and behavioural deficits. This is important in determining where seizures may arise or problems arising from seizures.
The study of the relationship between brain function, and behaviour, emotion, and cognition.
A surgeon who operates on the nervous system - the brain, spinal cord, spinal column and nerves.
Chemicals produced by nerve cells, necessary for the transportation of electrical signals in the nervous system.
Night terrors -
A sleep disorder occurring mainly in young children. They have episodes of screaming, intense fear and sometimes thrashing about or sleepwalking while still asleep.
Nocturnal Seizures -
Seizures that occur during sleep.
Non-epileptic seizures -
See psychogenic non-epileptic seizures (PNES).
where there is no physical signs such as motion or movement
Pertains to the back of the head where the occipital lobe of the brain is located. The main function of the occipital lobe is vision.
Occupational therapist -
Work with people to enhance their ability to engage in the activities they want to, need to, or are expected to do, or by modifying the activity or the environment to better support them.
ovarian cysts -
An accumulation of fluid within an ovary that is surrounded by a very thin wall forming a sac-like structure. Most ovarian cysts are benign (harmless).
The part of the female menstrual cycle where the ovary discharges an egg and it travels down the fallopian tube.
Also known as Trileptal. It is an antiepileptic drug used in the management of focal and generalised onset seizures.
Parietal lobe -
Pertains to the part of the brain located behind the frontal lobes, above the temporal lobes and in front of the occipital lobes. The main function is sensation, perception of where the body is.
Pertaining to a sudden outburst, such as the sudden recurrence of symptoms or burst of epileptiform activity on the EEG.
Partial Seizures -
See focal seizures
The study of how normal physiological processes are affected by disease.
The act of persisting or persevering, continuing or repeating behaviour.
Positron emission tomography. A diagnostic scan that uses a dose of radioactive glucose to measure metabolic activity in the body and brain.
Petit Mal -
An older term for absence seizures. See absence seizure. It is sometimes used incorrectly to refer to any seizure that is not convulsive, eg partial seizures.
The study of the metabolism and action of drugs in the body. It involves absorption, duration of action, distribution in the body, and method of elimination.
A barbiturate drug sometimes used to treat seizures, particularly in the short-term or acute situations. It is also used for sedation.
Also known as Dilantin. An older antiepileptic drug used in the treatment of epilepsy and seizures.
Photic stimulation -
Using strobe or flashing lights at different frequencies during an EEG to detect photosensitive epilepsy.
Photosensitive epilepsy -
A form of epilepsy in which seizures can be triggered by flashing or flickering lights and/or geometric shapes or patterns.
Polycystic ovaries -
When the ovaries develop a large number of small cysts.
Taking more than one medication.
The period following a seizure. During this time a person may be confused and drowsy.
Postural Strength -
Strength referring to (in general terms) the muscles forming around and the trunk of the body including the abdominal, oblique (sides), mid and lower back. Also called core strength.
To be more susceptible to a disease or condition.
Doctor's written order to use a medication or other treatment.
A female hormone produced in the ovaries and adrenal glands, involved in the menstrual cycle and reproduction.
The outcome of a medical condition such as, the chances the condition will improve, remain unchanged or worsen.
Refers to the spreading of seizure activity in the brain
A older term referring to psychogenic non-epileptic seizures, no longer used. See psychogenic non-epileptic seizures.
Psychogenic non-epileptic seizures -
Are involuntary changes in behaviour and movement linked to psychological or social distress. These events look like epileptic seizures, but are not caused by abnormal activity in the brain. They are often triggered by an emotional or psychological cause rather than a physiological one and can be seen in people with or without epilepsy.
Relating to, or arising from the mind or emotions.
Psychomotor Seizures -
An older term for focal onset seizures.
Reading epilepsy -
A type of reflex epilepsy where seizures are triggered by reading. There is jerking of the jaw, which can evolve to a generalised seizure, especially if the person keeps reading. There is a genetic basis and a positive family history in about 25% of cases.
Reflex epilepsy -
is a type of epilepsy in which seizures can be provoked regularly by an external stimulus or, less commonly, internal mental processes.
REM sleep -
Rapid Eye Movement. A stage in the normal sleep cycle during which dreams occur and the body undergoes changes including Rapid Eye Movement, muscle relaxation, and increased breathing and heart rate and brain activity.
Rolandic epilepsy -
See benign focal epilepsy of childhood.
Rote learning -
Learning something by memorising by repeating it, over and over again.
Is a scoring tool that teachers use to assess student learning after a lesson.
Secondarily generalised seizure -
see focal to bilateral tonic clonic seizure
A seizure is a disruption in the normal pattern of electrical impulses in the brain. This can cause changes in sensation, awareness, and behaviour, or sometimes convulsions, muscle spasms or loss of consciousness, depending on where the seizure starts and spreads in the brain.
Self talk -
Talking to yourself either aloud or silently in your head.
Side effects -
Any unwanted effect of a drug that happens in addition to the main effect. Sometimes these side effects are unpleasant or dangerous.
Simple partial seizure -
see focal aware seizure
Sodium Valproate -
Also known as Epilim or Valpro. Used in the management of focal and generalised onset seizures. Can also be used to treat mood disorders, particularly mania.
Single Photon Emission Computerised Tomography. A diagnostic scan sometimes used to determine blood flow within the brain. SPECT can be performed on people with epilepsy who are working up for possible surgery for epilepsy.
Spike and wave complex -
An EEG pattern which is characteristic in some forms of epilepsy.
Status epilepticus -
Is a condition where there is a prolonged seizure or repeated seizures without regaining consciousness for 5 mins or more. They can be convulsive or non-convulsive and can be life-threatening if they continue.
A mark of shame about a condition or behaviour that is not generally accepted as the norm generally due to negative attitudes and beliefs.
A substance that raises levels of physiological or nervous activity in the body.
Plans of action designed to achieve a goal or deal with contingencies
Sturge-Weber Syndrome -
is a congenital abnormality typically involving a facial birthmark (called a port wine stain or angioma) and a leptomeningeal angioma (or birthmark on the brain). Neurological symptoms can include seizures, developmental delay or intellectual disability, weakening of one side of the body and visual deficits. The brain involvement is mostly on one side but can also be on both sides of the brain. Seizures can be severe and difficult to control.
continuing for a lengthy period without interruption
Also known as Teril or Carbamazepine. See Carbamazepine.
An older term form video EEG – A technique for recording seizures on video with simultaneous EEG; changes in behaviour can be correlated with changes in the EEG; very useful diagnostic tool for epilepsy. Mostly termed VEEG.
Temporal lobe -
The lobes in the brain situated beneath the temples. Seizures commonly originate in this region in the focal epilepsies. The temporal lobe is associated with memory, speech, language, learning and behaviour.
Tetrahydrocannabinol is the main component of the cannabis (marijuana) plant that affects brain function.
Also known as Gabitril. Used in partial and secondarily generalised seizures.
Repeated involuntary contractions of muscles, such as sniffing, clearing the throat, rapid head jerks or eye blinks.
Todd’s paralysis -
Weakness or paralysis occurring in one limb or one side of the body after a seizure. Usually resolves in one or two hours but may, on occasion, continue for several days.
Increased muscle tone, stiffening of the muscles
Tonic seizure -
A seizure that causes brief muscle stiffening and if standing, the person will fall rapidly to the ground. Tonic seizures can also happen in sleep. They are more likely to be seen in people with complex epilepsy syndromes. Also termed ‘drop attacks’
Tonic-clonic seizure -
These are the most universally recognised seizures. They often begin with a sudden cry, the body becomes quite stiff (tonic) shortly followed by jerking of the muscles (clonic). The seizure usually lasts no more than 2 minutes and is followed by a period of confusion, agitation or sleep. Headaches and soreness are common afterwards. Previously called “Grand Mal”
Also known as Topamax. Used in focal and generalised onset seizures. Also used in Lennox -Gastaut syndrome.
Identifiable causes or provocation of seizures in an individual, often referred to as seizure triggers.
Tuberous sclerosis -
Is an inherited condition which benign tumours affect the brain, eyes, skin and internal organs. Epilepsy occurs in 80% of people affected, and the type of seizures are strongly age related.
A growth of abnormal tissue characterised by progressive, uncontrolled proliferation of cells.
Unknown onset seizures -
A classification of seizures that cannot be diagnosed as either a focal or generalised and are thus grouped as unknown.
Vagus Nerve Stimulation (VNS) -
A pacemaker like generator is surgically placed under the skin in the chest with a stimulating lead attached to the vagus nerve. Intermittent stimulation of the left vagus nerve in the neck is given to reduce the frequency and intensity of seizures.
See Telemetry – video EEG
Video EEG telemetry -
See Telemetry – video EEG
Susceptible (to physical or emotional injury).
Wada test -
An test used occasionally prior to surgery for epilepsy. It is used to determine the area of speech, memory and language in the brain.
West syndrome -
See Infantile spasms
withdrawal seizure -
A seizure which may occur due to suddenly stopping antiepileptic medications, tranquilisers or alcohol (chronic drinkers).