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The aims of this study were to identify risk factors for AWS recurrence and to study the overall outcome of patients after AWS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective single\u2010center study, we included patients who were admitted to the Emergency Department after an AWS between January 1, 2013 and August 10, 2021 and for whom an electroencephalogram (EEG) was requested. AWS relapses up until April 29, 2022 were researched. We compared history, treatment with benzodiazepines or antiseizure medications (ASMs), laboratory, EEG and computed tomography findings between patients with AWS relapse (r\u2010AWS) and patients with no AWS relapse (nr\u2010AWS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 199 patients were enrolled (mean age 53\u2009\u00b1\u200912\u2009years; 78.9% men). AWS relapses occurred in 11% of patients, after a median time of 470.5\u2009days. Brain computed tomography (<jats:italic>n<\/jats:italic>\u2009=\u2009182) showed pathological findings in 35.7%. Risk factors for relapses were history of previous AWS (<jats:italic>p<\/jats:italic>\u2009=\u20090.013), skull fractures (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) at the index AWS, and possibly epileptiform EEG abnormalities (<jats:italic>p<\/jats:italic>\u2009=\u20090.07). Benzodiazepines or other ASMs, taken before or after the index event, did not differ between the r\u2010AWS and the nr\u2010AWS group. The mortality rate was 2.9%\/year of follow\u2010up, which was 13 times higher compared to the general population. Risk factors for death were history of AWS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and encephalopathic EEG (<jats:italic>p<\/jats:italic>\u2009=\u20090.043).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Delayed AWS relapses occur in 11% of patients and are associated with risk factors (previous AWS &gt;24\u2009h apart, skull fractures, and pathological EEG findings) that also increase the epilepsy risk, that is, predisposition for seizures, if not treated. Future prospective studies are mandatory to determine appropriate long\u2010term diagnostic and therapeutic strategies, in order to reduce the risk of relapse and mortality associated with AWS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16075","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T13:05:03Z","timestamp":1697115903000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Long\u2010term outcome of alcohol withdrawal seizures"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3685-7108","authenticated-orcid":false,"given":"Giulio","family":"Sansone","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences University Hospital of Geneva &amp; Faculty of Medicine  Geneva Switzerland"},{"name":"Department of Neuroscience University of Padova  Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Megevand","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences University Hospital of Geneva &amp; 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