Alcoholic tremor

Introduction Alcoholic tremor is a common clinical symptom of alcoholic brain atrophy. Alcoholic cerebral atrophy refers to the irreversible reduction of brain tissue caused by chronic alcohol consumption. Whether the disease constitutes an independent clinical pathological disease is controversial. Specifically refers to relatively young alcoholics, clinical or no brain lesions, cerebral angiography showed lateral ventricle enlargement, frontal sulci widening.

Cause

(1) Causes of the disease

It has indeed been confirmed that a large number of uncontrolled drinking alcohols have a great detrimental effect on many organ systems of the body, and the nervous system is one of the main target organs of alcohol abuse.

(two) pathogenesis

The pathogenesis of brain atrophy caused by alcoholism is unclear. May be caused by a variety of reasons, such as vitamin B1 deficiency or nutritional disorders, but it is also believed that direct damage to the brain caused by alcohol caused by neuronal loss. Some literature suggests that the test proves that alcohol can dissolve in fat, but it can also dissolve fat. The highest fat content in various organs of the human body is nerve tissue, and the brain is in the first place. Long-term chronic alcohol exposure, neuronal damage caused by corresponding dysfunction is inevitable.

an examination

Related inspection

Brain ultrasound examination EEG examination

A CT scan revealed a change in brain atrophy such as deepening of the sulci, widening of the cerebral fissure, and enlargement of the symmetry of the ventricle, and does not represent an irreversible loss of brain tissue. In recent years, through CT or MRI studies, it has been found that such CT changes seen by some alcoholics are reversible to varying degrees. This reversibility indicates that the fluid in the brain has metastasized rather than lost brain tissue. This may be related to the return of normal water and electrolytes in the brain after alcohol withdrawal. It may also be involved in the regeneration of glial cells and neuronal proteins.

The correlation between these imaging findings and clinical findings is far from clear. In some patients, brain atrophy is often accompanied by obvious alcoholic complications. There are reports of pathological data of Wernicke-Korsakoff syndrome. About 1/4 of the patients show lateral ventricle, third ventricle enlargement, and frontal lobe cerebral atrophy. Other alcoholics have a widening of the ventricles due to recurrent epileptic seizures, or liver disease, brain trauma, and other factors. However, some alcoholics found that the ventricles were enlarged, but during the whole process, routine neurological examination and intelligent state tests did not reveal the symptoms and signs of neuropsychiatric diseases.

1. Brain atrophy is more common in men with a long history of heavy drinking, and generally has chronic alcoholism. More common in middle-aged and older people. Insidious onset, and gradually progress slowly.

2. The main feature is that there are often anxiety, headache, insomnia, fatigue, etc., and mental retardation and personality changes gradually appear. Unless there is severe brain atrophy, there is usually no obvious dementia. Can maintain good working ability for a long period of time. The patient complained of significant memory loss and decreased ability to calculate, judge, and analyze. A small number of Korsakoff psychosis manifestations of amnesia, fiction and disorientation. Personality changes can be selfish, life is boring, emotionally unstable, irritating, work inefficient, lack of responsibility, disobedient advice, and interpersonal tensions. In severe cases, there is a smart decline and a significant decline in IQ.

3. Some patients may have peripheral neuropathy and muscle atrophy, and even tremors and hallucinations. The performance of severe alcoholism such as delusions and epileptic seizures.

4. Head CT shows the manifestation of brain atrophy such as sulcal widening, small brain return, brain pool and ventricular enlargement.

Differential diagnosis

Need to be identified with the following symptoms:

Physiological tremor: more common in the distal part of the limb, a posture shock. The amplitude is small and difficult to detect with the naked eye. If the paper is placed on the back of the finger that is stretched forward, the tremor is easier to find. The frequency of tremor varies with age, usually about 6 times/second under 9 years old; about 10 times/second at 16 years old; the frequency of tremors starts to slow down after 40 years old, and returns to 6 seconds after about 70 years old/ second. In addition to the hand, tremor can still be found in the eyelids, the tongue muscles, the trunk and the lower limbs.

Functional tremor: Tremor is a certain direction, involuntary, rhythmic or arrhythmic vibration of a part or all of the body. More common in the hands, feet, tongue, eyelids and other corners. Head and lower limbs are rare. Functional tremor: The amplitude of tremor is more physiological than normal, and can be detected by the naked eye. The cause can be seen in hypoglycemia, pheochromocytoma, hyperthyroidism, alcoholism, and drug poisoning. Also seen in normal people's emotional excitement, excessive fatigue, panic, anger, squatting, strenuous exercise, etc. Caries tremor also belongs to this category, its tremor is often irregular, the site is not fixed, often accompanied by psychological disorders and other signs of rickets.

Intentional tremor: Intentional tremor refers to tremor that occurs during voluntary exercise. It is characterized by the most obvious in targeted movements or when the target is to be achieved, often in the cerebellum and its efferent pathway lesions. Intentional tremor can be accompanied by a decrease in muscle tone and occurs only during limb movement.

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