Alcohol withdrawal tremor

It is well known that during the withdrawal period after chronic alcohol intake, tremor is one of the symptoms that disturb patients. Alcohol withdrawal tremor might be a variant of enhanced physiological tremor, most often caused by anxiety or emotional stress. The aim of this investigation was to establish the EMG pattern of alcoholic tremor and to compare it with the well known pattern of enhanced physiological tremor caused by anxiety or emotional stress. Forty patients 20-43 years old were investigated by a neurologist and psychiatrist 1-10 days after acute alcohol withdrawal. They all met the criteria for chronic alcoholism. Thirty three patients 26-43 years old with the complaint of tremor and anxiety or emotional stress were also investigated. An electromyographic investigation was performed to evaluate the pattern, frequency and amplitude of tremor. Results revealed that both groups of patients had 8-12 Hz low amplitude postural tremor with synchronous activity in antagonist muscles. Patients with alcohol withdrawal tremor had significantly higher amplitude tremor compared with patients with anxiety and emotional stress. No other clinical or electromyographic differences existed between both groups. In conclusion alcohol withdrawal tremor is a variant of enhanced physiological tremor. Both types of tremor could be distinguished only by the circumstances responsible for tremor occurrence.