A 70-year-old woman is brought to the emergency department after a fall. She lives alone and was…

A 70-year-old woman is brought to the emergency department
after a fall. She lives alone and was found by a neighbor who overheard her
screams. Her neighbor helped her get up, but she found that she could not walk
and had trouble maintaining her balance. Her neighbor also noted that there
were many empty bottles of vodka in her apartment. On examination, the patient
is alert and cooperative. She has an unsteady, wide-based gait and a positive
Romberg test. She has obvious dysmetria on finger-to-nose and heel-to-shin
testing. Her x-rays show osteopenia, and her head magnetic resonance
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A 70-year-old woman is brought to the emergency department
after a fall. She lives alone and was found by a neighbor who overheard her
screams. Her neighbor helped her get up, but she found that she could not walk
and had trouble maintaining her balance. Her neighbor also noted that there
were many empty bottles of vodka in her apartment. On examination, the patient
is alert and cooperative. She has an unsteady, wide-based gait and a positive
Romberg test. She has obvious dysmetria on finger-to-nose and heel-to-shin
testing. Her x-rays show osteopenia, and her head magnetic resonance imaging
shows mild cerebral and cerebellar atrophy. Her blood alcohol level is 0.08%;
other laboratory test results are normal.

Questions

A. What is the likely cause of the patient’s fall and
neurologic findings?

B. What are the common clinical features of this condition?

C. If many members of her family, including individuals who
never used alcohol, had similar symptoms, what neurologic disorder might you
suspect?

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