Nieschalk M, Ortmann C, West A, Schmäl F, Stoll W, Fechner G
Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Westfälische Wilhelms-Universität Münster, Germany.
Int J Legal Med. 1999;112(4):253-60. doi: 10.1007/s004140050245.
The vestibulospinal aspects of vestibular function are commonly neglected in the evaluation of alcohol-induced intoxication. Thus, in the present study the effect of an acute intoxication with a low or moderate quantity of alcohol was examined with respect to the equilibrium in 30 healthy subjects. The blood alcohol concentration (BAC) was measured 30 min after the ingestion of the last alcohol, ranging between 0.22 and 1.59 per thousand. Stability of stance was quantified by static platform posturography in Romberg-test conditions with eyes open and eyes closed. Among other parameters, the average body sway path (SP) and area of body sway (SA) were assessed. Posturography revealed a significant increase in body sway. There was a positive correlation between SA (or SP) and BAC both with eyes open and eyes closed. Multiple group comparisons revealed that the large-alcohol-dose group (BAC > or = 1.0 per thousand) could be clearly differentiated from test cases with BAC lower than 0.8 per thousand. Sway area was the most sensitive parameter for detecting increased body sway after alcohol ingestion. The area increase, present not only with eyes closed but with eyes open, revealed an inadequate compensation of the ethanol-induced ataxia by visual stabilization. The Romberg's quotient, which denotes eyes closed relative to eyes open, remained constant. The increase in sway path with eyes closed showed an omnidirectional sway. A comparison of the sway pattern of subjects after acute ethanol ingestion with the data of patients with permanent cerebellar lesions suggested that the acute effect of alcohol resembles that of a lesion of the spinocerebellum. This finding contrasts with earlier studies, which postulated an acute effect of ethanol resembling that in patients with an atrophy of the anterior lobe of the cerebellum due to chronic alcohol abuse. In seven cases of the lower dose group (BAC < or = 0.8 per thousand), a reduction in body sway after alcohol ingestion was observed. This finding may be consistent with a dose-related biphasic action of alcohol, which - besides its well-known depressant effects with high doses - also shows stimulatory action with small doses.
在前庭功能的评估中，酒精中毒导致的前庭脊髓方面的影响通常被忽视。因此，在本研究中，我们检测了30名健康受试者摄入少量或适量酒精导致急性中毒后对平衡能力的影响。在摄入最后一次酒精30分钟后测量血液酒精浓度（BAC），范围在千分之0.22至1.59之间。通过在睁眼和闭眼的罗姆伯格测试条件下使用静态平台姿势描记法对站立稳定性进行量化。除其他参数外，还评估了平均身体摆动路径（SP）和身体摆动面积（SA）。姿势描记法显示身体摆动显著增加。睁眼和闭眼时，SA（或SP）与BAC之间均呈正相关。多组比较显示，高酒精剂量组（BAC≥千分之一）与BAC低于千分之0.8的测试病例可明显区分。摆动面积是检测酒精摄入后身体摆动增加的最敏感参数。面积增加不仅在闭眼时出现，睁眼时也出现，这表明视觉稳定对乙醇诱导的共济失调补偿不足。表示闭眼相对于睁眼情况的罗姆伯格商保持不变。闭眼时摆动路径的增加显示为全方位摆动。将急性乙醇摄入后受试者的摆动模式与永久性小脑病变患者的数据进行比较表明，酒精的急性作用类似于脊髓小脑病变的作用。这一发现与早期研究形成对比，早期研究推测乙醇的急性作用类似于慢性酒精滥用导致小脑前叶萎缩患者的作用。在低剂量组的7例受试者（BAC≤千分之0.8）中，观察到酒精摄入后身体摆动减少。这一发现可能与酒精的剂量相关双相作用一致，即除了高剂量时众所周知的抑制作用外，小剂量时还表现出刺激作用。
