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Selected Publication:
Ghadery, C.
Alcohol response in different tremor syndromes based on anamnestic survey
Is subjective alcohol response a discriminatory factor to distinguish between tremor disorders?
[ Diplomarbeit ] Graz Medical University; 2012. pp. 69
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- Authors Med Uni Graz:
- Advisor:
- Schmidt Reinhold
- Schwingenschuh Petra
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- Abstract:
- Aims: A positive response to alcohol, commonly simply inquired by history, is used as a supportive diagnostic criterion for essential tremor (ET). In fact only a few studies exist on the effect of alcohol in ET and idiopathic Parkinson¿s disease (IPD). So far no systematic studies have been performed in other tremor syndromes. Therefore we wanted to investigate if subjective alcohol response distinguishes between a broad range of tremor disorders. Methods: We recruited 55 consecutive patients (28 men, 27 women) with upper limb tremor and an established diagnosis based on diagnostic criteria. Besides a neurological examination a questionnaire was used to obtain information on demographics, alcohol drinking habits, and response of tremor to oral alcohol intake. Our cohort consisted of 27 patients with IPD, three with dystonic tremor (DT), nine with tremor associated with dystonia (TaD), seven with ET, three with enhanced physiological tremor, two with atypical parkinsonian syndromes, one with Fragile-X-Tremor-Ataxia-Syndrome, two with Klinefelter syndrome associated tremor, and one with psychogenic tremor. Statistical analyses were performed comparing all groups. Due to small numbers of some diagnostic entities we also performed statistical analyses comparing the following groups: 1.ET, 2.IPD, 3.dystonic tremor (DT) and tremor associated with dystonia (TaD), 4. all others). Results: Forty-four out of 55 patients were drinking alcohol (mean 5.4±5.0 units/week). Of these 44 patients, 14 reported no response, 14 improvement of tremor, and 16 had never paid attention to the effect of alcohol on their tremor. The 14 patients with a positive alcohol effect rated the improvement of tremor as 54±2%, for a duration of 3.7±3.1 hours, after a mean intake of 3.9±3.6 units alcohol. Only four patients reported to experience a rebound phenomenon and only one patient stated to drink alcohol because of its anti-tremor effect. None of the evaluated parameters differed significantly between the groups. Conclusion: Subjective alcohol response inquired by history cannot distinguish between different tremor disorders and is thus unlikely to serve as a supportive diagnostic criterion for ET. However, investigations of a larger sample size combined with an objective evaluation of alcohol responsiveness in different tremor disorders are necessary to shed further light on this topic.