ATAXIA OF STANCE IN DIFFERENT TYPES OF ALCOHOL DEPENDENCE - A POSTUROGRAPHIC STUDY

The aim of this study was to assess the prevalence of ataxia of stance in different types of alcohol-dependent patients. Posturographic meas urements were performed in 82 abstinent alcohol-dependent patients and 54 healthy controls in order to analyse postural control. According t o Lesch and co-workers, alcohol dependence was classified as total abs tinence (Type I), drinking without loss of control (Type II), fluctuat ing course (Type III), and persistent severe drinking (Type IV). The m echanisms of alcohol dependence in these subtypes can be summarized as follows: Type 1 patients drink alcohol to counteract symptoms of alco hol withdrawal; Type II patients use alcohol as an agent for solving c onflicts; Type III patients drink alcohol to 'treat' an affective diso rder; and Type IV patients have a history of pre-alcoholic neurologica l and/or psychiatric disorders. The neurological examination showed pa thological findings in 39%, whereas posturographic measurements uncove red impaired postural control in 61% (chi(2) = 8.8, P = 0.003). Compar ing the different study groups revealed that ataxia of stance was most common in alcohol-dependent patients classified as Type IV (tau = 0.2 4, P = 0.005). In conclusion, posturographic measurements are superior to the clinical examination in detecting postural imbalance in alcoho l-dependent patients. The prevalence of postural imbalance is highest in patients classified by Lesch as Type IV. Consequently, this type of alcohol dependence - characterized by pre-alcoholic neurological and/ or psychiatric disorders, bears the highest risk of developing ataxia of stance.