Extrapyramidal dysfunction in alcoholism.

Chronic, excessive ingestion of alcohol, with its accompanying subnutrition and intermittent drug withdrawal (partial or complete), has produced many neurologic disorders. These problems include involuntary movement disorders which may be reviewed under three major headings: withdrawal tremulous states, cerebellar system dysfunction, and hepatic related disorders.The tremor of alcohol withdrawal resembles that of physiologic tremor when exacerbated by anxiety. It is the most common neurologic manifestation of alcohol withdrawal, and the tremor amplitude is usually greatest some 10 to 20 hours after cessation of drinking. A tremulous state, which may be transient or persistent, also occurs in infants born to alcoholic mothers.The common hepatic encephalopathy may be accompanied by a flapping tremor and multiple other tremors and jerking movements. Chronic porto-systemic encephalopathy is accompanied by choreoathetoid movements and persistent coarse tremors.