Influence of alcohol on gait in patients with essential tremor.
OBJECTIVE
To study the effect of ethanol on gait in patients with essential tremor (ET).


METHODS
Using a three-dimensional opto-electronic gait analysis system, the authors analyzed gait at free-speed walking, at a given velocity, and during tandem gait. Patients with ET with advanced disease were examined before and after a small oral dose of ethanol. The results of the patients with ET were compared with those from age-matched healthy controls (HCs). The primary outcome criteria were the number of missteps and the ataxia score during tandem gait.


RESULTS
Before alcohol, patients with ET had more missteps and an abnormal ataxia score compared with HCs. The ingestion of alcohol with a mean blood level of 0.45% led to a significant improvement of the ataxia score and the number of missteps. HCs showed a worsening of the ataxia score and an increase of the number of missteps after alcohol, which failed to reach significance.


CONCLUSIONS
Orally administered ethanol improved gait ataxia in patients with essential tremor (ET). This may reflect a reversible effect of ethanol on receptors being involved in the pathology of ET. Ethanol may act via an influence of the inferior olive or directly on alcohol-sensitive gamma-aminobutyric acid receptors within the cerebellum.
Klebe
S
S
Department of Neurology, Christian-Albrechts-Universität Kiel, Germany.
Stolze
H
H
Grensing
K
K
Volkmann
J
J
Wenzelburger
R
R
Deuschl
G
G
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000187:drug effects* / Q000502:physiology / Q000503:physiopathology; D002492:Central Nervous System Depressants / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use; D002531:Cerebellum / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology; D020329:Essential Tremor / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D000431:Ethanol / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D020233:Gait Disorders, Neurologic / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D009433:Neural Inhibition / Q000187:drug effects / Q000502:physiology; D009434:Neural Pathways / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology; D009847:Olivary Nucleus / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology; D018079:Receptors, GABA / Q000187:drug effects; D016896:Treatment Outcome
D002492:Central Nervous System Depressants; D018079:Receptors, GABA; D000431:Ethanol