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Influence of alcohol on gait in patients with essential tremor

From the Department of Neurology, Christian-Albrechts-Universität Kiel, Germany.

Address correspondence and reprint requests to Dr. G. Deuschl, Neurologische Klinik der Christian-Albrechts-Universität zu Kiel, Schittenhelmstr.10, 24105 Kiel, Germany; e-mail: g.deuschl{at}neurologie.uni-kiel.de

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 -aminobutyric acid receptors within the cerebellum.

Supported by the German Research Council (DFG).

Received December 16, 2004. Accepted in final form March 18, 2005.

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