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Alcoholic Neuropathy
Nerve Disease due to Alcohol Ingestion

Alcoholic neuropathy is a neurological disorder induced by long-term alcohol abuse. It is primarily associated with sensory alterations, but may also be characterized by weakness and pain.

Images

WIKIDATA, Public Domain
WIKIDATA, CC0 1.0
WIKIDATA, Public Domain
WIKIDATA, CC0 1.0
WIKIDATA, CC BY-SA 3.0

Presentation

AN is related to chronic alcohol abuse, and the disease follows a slowly progressive course. Superficial sensory alterations are noted first and dominate the clinical picture throughout the disease [6]. Patients typically claim intense, burning pain in the lower limbs. Both hyperalgesia and allodynia have been reported. As the disease progresses, the arms become involved while sensory deficits and weakness set in [5]. Due to reduced sensations in arms and legs, AN patients are prone to injuries. Affected individuals frequently describe paresthesias, which are initially noted in hands and feet, but that subsequently progress towards proximal portions of the extremities. An unsteady gait and walking disabilities may be observed in advanced stages of the disease. In AN patients, muscle strength is largely unaltered [7].

Entire Body System

  • Malnutrition

    Alcoholic polyneuropathy may be suspected when such findings occur in the setting of long-standing alcoholism and malnutrition. [ncbi.nlm.nih.gov]

    The results confirm that ethanol plays a definitive role in the development of alcoholic neuropathy and that malnutrition accentuates, the histopathological abnormalities [6]. [wikigenes.org]

    Alcoholic polyneuropathy may be suspected when such findings occur in the setting of long‐standing alcoholism and malnutrition. [dx.doi.org]

  • Fever

    In severe cases, you could have a fever, seizures, or hallucinations. If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more serious the problem is. [icdlist.com]

Gastrointestinal

  • Overeating

    Alcoholic Neuropathy is a very serious form of nerve damage that can develop if a person drinks heavily over a long period of time. [addictionsearch.com]

    Diabetes is the number one cause of peripheral neuropathy because high blood sugar is extremely damaging to nerves over the long-term. [healthclover.com]

    Seek medical advice from your doctor, over the counter or prescribed medication must be advised to control the pain cause by alcoholism neuropathy. Over the counter medicine such as aspirin or ibuprofen can be use as pain reliever. [nlcatp.org]

    Over the last six months, while he was no longer able to play music, he continued to tour with his band and party, party, party, and he continued to get worse and worse. Slowly, over time, he has almost lost his ability to walk. [neurotalk.org]

  • Fecal Incontinence

    No patient displayed cranial nerve involvement, urinary or fecal incontinence, or central nervous system signs. No patient required assisted mechanical ventilation. [jamanetwork.com]

Musculoskeletal

  • Muscle Spasm

    Seek immediate medical care for serious symptoms, such as numbness or tingling in your legs or arms, loss of bladder or bowel control, muscle spasms, muscle weakness, and speech impairment. [healthgrades.com]

    Symptoms of alcoholic neuropathy include: loss of sensation and numbness, tingling, pain, burning, muscle spasms and muscle weakness. Nerve damage caused by overuse of alcohol is usually permanent. [doctorvikki.com]

    As the condition progresses, additional signs may include: Weakness, pain, numbness or tingling that spreads to other parts of your upper or lower extremities Muscle spasms or muscle aches A severe case of alcoholic neuropathy may also alter the function [promises.com]

    Hershey Medical Center at Penn State University states that damage can manifest as weakness, muscle spasms and involuntary contractions. These symptoms can impair the ability to perform normal everyday movements. [livestrong.com]

    People can experience weakness of the muscles, muscle spasms, achy muscles or even muscle cramps. Impotency in men is another symptom of alcohol neuropathy. Another major concern can be problems with urination. [addictionsearch.com]

  • Numbness of the Feet

    Overview Peripheral neuropathy, a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body. [mayoclinic.org]

  • Restless Legs Syndrome

    Lyme disease community... by MuonOne 05-04-2019 03:25 PM 146 644 Health Conditions M - Z Movement Disorders (2 Viewing) Including essential tremor, dystonia and Restless Leg Syndrome (RLS). [neurotalk.psychcentral.com]

Skin

  • Hyperhidrosis

    Autonomic disturbances were present in all patients, consisting of hyperhidrosis or tachycardia. Tachycardia resolved within 2 to 3 weeks after admission; however, hyperhidrosis persisted throughout the period of observation. [jamanetwork.com]

Urogenital

  • Incontinence

    These symptoms include: Limbs–numbness, tingling, burning, or prickly sensation, muscle cramps, weakness, thinning and loss of muscle function, movement disorders Urinary incontinence, problems with urinating Bowel incontinence, constipation, diarrhea [med-health.net]

    It may lead to incontinence or male impotence. In some cases, there is damage to the autonomic nervous system, which, among other things, affects heart rate and breathing. [neillneill.com]

    Neuropathy Symptoms Numbness in the arms and legs Abnormal sensations; “pins and needles” Painful sensations in the arms and legs Muscle weakness Muscle cramps or muscle aches Heat intolerance, especially after exercise Impotence (in men) Problems urinating Incontinence [ragingalcoholic.com]

    Impairment of the nerves involved in supplying the urinary tract can result in incontinence or difficulty urinating, both of which are common occurrences in cases of alcoholic neuropathy. [livestrong.com]

  • Sexual Dysfunction

    The main symptom of alcohol neuropathy ispain and tinglinginthe limbsand other symptoms include sexual dysfunction,Impotence, impairedspeech,difficultyswallowing,heatintolerance. Life style Modification: You can avoid alcoholic neuropathy by: 1. [slideshare.net]

    When this happens, the internal organs are affected which can cause sexual dysfunction and digestive problems among other things Vitamin B supplements, especially thiamine, are often helpful to suppress alcoholic neuropathy Many alcoholics suffer from [cidpusa.org]

    Common symptoms include pain, tingling, weakness and burning in the legs and feet, but some people also experience muscle spasms, diarrhea, incontinence, impaired speech, impotence and sexual dysfunction. [footfiles.com]

    Specialized medications for incontinence : Medications for bowel and bladder issues and for sexual dysfunction may be needed in some cases. Special appliances : Orthopedic aids, such as braces and other appliances to help with movement, can help. [lagunatreatment.com]

    When this happens, the internal organs are affected which can cause sexual dysfunction and digestive problems, among other things. [healthclover.com]

  • Urinary Incontinence

    These symptoms include: Limbs–numbness, tingling, burning, or prickly sensation, muscle cramps, weakness, thinning and loss of muscle function, movement disorders Urinary incontinence, problems with urinating Bowel incontinence, constipation, diarrhea [med-health.net]

    incontinence Incomplete bladder emptying Impotence in men Abnormal intolerance to heat Diarrhea Constipation Nausea or vomiting Treatment and Long-Term Prognosis The nerve damage caused by alcoholic neuropathy is permanent in most cases. [promises.com]

    Some common symptoms of alcoholic neuropathy include urinary incontinence, problems when urinating, feeling as if bladder is not completely emptied or difficulty to begin with urination. [epainassist.com]

Neurologic

  • Peripheral Neuropathy

    Another form of peripheral neuropathy is caused by exposure to toxins, such as pesticides and heavy metals, and is equally detrimental to health. People who have undergone chemotherapy can experience peripheral neuropathy as well. [texasfootdoctor.org]

    We suggest that a defect in thiamine utilization is involved in peripheral neuropathy of alcoholics, rather than a lack of thiamine itself. [ncbi.nlm.nih.gov]

    Description Peripheral Neuropathy is a nerve condition that affects the arms, hands, legs, and feet. The most common form of peripheral neuropathy is due to diabetes. [ahni.com]

    A person with this condition is at the same risk, and should take the same precautions as people with diabetic peripheral neuropathy. [firstcoastfootclinic.com]

  • Dizziness

    Dizziness and Lightheadedness Dizziness and lightheadedness may occur when you are standing up. [med-health.net]

    Orthostatic hypotension causes dizziness, lightheadedness and sometimes fainting during sudden changes in position, such as moving from a sitting to a standing position. [livestrong.com]

    […] anticonvulsants) medication for people with problems urinating physical therapy to help with muscle atrophy orthopedic appliances to stabilize extremities safety gear, such as stabilizing footwear, to prevent injuries special stockings for your legs to prevent dizziness [healthline.com]

  • Foot Drop

    Foot braces may also be helpful if you have problems with foot drop. If you have weakness in your arms, a wrist splint may be helpful. A physiotherapist may be the best person to help you with such aids. [patient.info]

  • Unable to Walk

    Very early after been diagnosed, before I had any symptoms, after having a few drinks I would be unable to walk due to my legs going into overdrive and forcing me to run, bearing in mind that this was my only issue it seemed bizarre but not too worrying [thisisms.com]

  • Confabulation

    Chronic heavy drinking may result in an irreversible loss of the short-term memory (seconds, minutes) and long-term memory (years) and ability to learn new things (Korsakoff psychosis) what often results in making stories (confabulation) to cover the [nutrientsreview.com]

Workup

The diagnosis of AN is based on a prior diagnosis of alcoholism which, in turn, relies on anamnestic data provided by the patient and third parties [8]. Although electrophysiological studies may be conducted to confirm a clinical diagnosis of polyneuropathy, findings such as decreased amplitudes of sensory potentials and mild to moderate reductions of nerve conduction velocities are not specific for AN [4].

Patients suffering from chronic alcoholism frequently present comorbidities such as alcoholic hepatitis, cardiomyopathy, and nutrient deficiencies. Workup should thus include studies to assess the condition of the respective organ systems and the patient's nutritional status. In this context, it should be noted that long-term alcohol abuse is associated with thiamine deficiency and possibly Wernicke-Korsakoff syndrome, a brain disorder. Even if thiamine deficiency is not a prerequisite for AN, it may modify the patient's clinical presentation [6] [9].

In detail, the following diagnostic measures may be undertaken [10]:

  • Laboratory analyses of blood samples, paying particular attention to liver enzyme levels (γ-glutamyltransferase, alanine aminotransferase, aspartate aminotransferase, ratio aspartate aminotransferase/alanine aminotransferase), carbohydrate deficient transferrin, markers of cardiac involvement (NT-proBNP, troponins, creatine kinase-MB), nutrient concentrations (thiamine, vitamin B12) and erythrocyte counts
  • Assessment of fasting glucose levels and glucose tolerance to rule out diabetic neuropathy
  • Imaging studies focusing on liver and brain
  • Electrocardiography, echocardiography

Treatment

They do not need to be shouting this off the rooftops, but they do need to be willing to go into treatment. There are ways to help someone become willing to get treatment for alcohol or treatment for drugs. [help4addiction.co.uk]

Free Expert Advice Available Now Speak with a treatment specialist 24/7 Privacy guaranteed Discuss your treatment options 877-322-2694 Free Expert Advice Available Now Speak with a treatment specialist 24/7 Privacy guaranteed Discuss your treatment options [learn-about-alcoholism.com]

Treatment of diabetic neuropathy (polyneuropathy) and alcoholic polyneuritis Treatment of diabetic and alcoholic neuropathy (polyneuropathy, polyneuritis) chosen individually in each case. [minclinic.ru]

These symptoms often respond poorly to treatment in people with alcoholic neuropathy. It is important to protect body parts with reduced sensation from injury. [stlukes-stl.com]

Prognosis

Prognosis of alcoholic peripheral neuropathy. Abstract Ten male alcoholics aged 38-72 years with clear clinical and electroneurographical signs of peripheral neuropathy were re-examined three to five years later. [jnnp.bmj.com]

What is the prognosis? The prognosis for a patient facing alcohol-related neuropathy is challenging to assess due to complications of addiction and alcoholism. [painhq.org]

Heavy drinking seems to worsen the prognosis of these neuropathies. [ncbi.nlm.nih.gov]

Despite the patient's poor prognosis and continued deterioration, he underwent a liver transplant in December 1999. Following the transplant, he noticed progressive recovery of strength in both legs. [news-medical.net]

Etiology

The lack of specific diagnostic criteria for alcoholic polyneuropathy requires that other potential etiologies be excluded before that diagnosis is made. [ncbi.nlm.nih.gov]

(Etiology) The exact cause of Alcoholic Neuropathy is unclear. [dovemed.com]

Epidemiology

Hedberg, Alcohol Consumption and Complaints from the Musculoskeletal System among Engine Drivers—an Epidemiological Study, Scandinavian Journal of Social Medicine, 16, 2, (105), (1988). E. Dahme, W. Kraft and J. [dx.doi.org]

Journal of Clinical Epidemiology 51, 697 –702. Behese, F. and Buchtal, F. ( 1977 ) Alcoholic neuropathy: clinical, electrophysiological and biopsy findings. Annales of Neurology 2, 95. [academic.oup.com]

Pathophysiology

The pathophysiology of alcoholic polyneuropathy is an area of current research. [en.wikipedia.org]

The pathophysiological mechanisms of polyneuropathy in patients with chronic alcohol abuse are still a matter of debate. [jamanetwork.com]

J. ( 1986 ) Alcoholic organic brain disease: nosology and pathophysiologic mechanism. Progress in Neuro-psychopharmacology and Biological Psychiatry 10, 147 –164. [dx.doi.org]

Prevention

[…] must be stopped to prevent the damage from getting worse. [stlukes-stl.com]

It is key to treat this condition immediately to prevent any further damage. [quitalcohol.com]

Summary

Long-term, excessive consumption of alcoholic beverages is known to adversely affect distinct organ systems. Chronic alcoholism may cause alcoholic hepatitis and cirrhosis, arrhythmias and alcoholic cardiomyopathy, alcoholic neuropathy (AN) and epilepsy [1]. A causal relation between alcohol abuse and hypertension has repeatedly been suggested but has recently been questioned [2] [3].

AN is a neurological, potentially reversible disorder affecting the peripheral nervous system. Histopathological analyses of biopsy specimens obtained from AN patients reveal an overall reduced nerve fiber density as well as axonal degeneration with diminished axonal sprouting [4]. The clinical equivalents of these lesions are a pain, increased sensitivity to pain, dysesthesias, and weakness. Abstinence is the mainstay of treatment, but patients may benefit from supportive measures such as physical and occupational therapy as well as dietary supplementation [5].

References

  1. Hillbom M, Pieninkeroinen I, Leone M. Seizures in alcohol-dependent patients: epidemiology, pathophysiology and management. CNS Drugs. 2003;17(14):1013-1030.
  2. Grogan JR, Kochar MS. Alcohol and hypertension. Arch Fam Med. 1994;3(2):150-154.
  3. Lip GY, Beevers DG. Alcohol and cardiovascular disease--more than one paradox to consider. Alcohol and hypertension--does it matter? (no!). J Cardiovasc Risk. 2003;10(1):11-14.
  4. Maiya RP, Messing RO. Peripheral systems: neuropathy. Handb Clin Neurol. 2014;125:513-525.
  5. Chopra K, Tiwari V. Alcoholic neuropathy: possible mechanisms and future treatment possibilities. Br J Clin Pharmacol. 2012;73(3):348-362.
  6. Koike H, Sobue G. Alcoholic neuropathy. Curr Opin Neurol. 2006; 19(5):481-486.
  7. Marchettini P, Lacerenza M, Mauri E, Marangoni C. Painful peripheral neuropathies. Curr Neuropharmacol. 2006;4(3):175-181.
  8. Madden JS. The definition of alcoholism. Alcohol Alcohol. 1993;28(6):617-620.
  9. Mellion M, Gilchrist JM, de la Monte S. Alcohol-related peripheral neuropathy: nutritional, toxic, or both? Muscle Nerve. 2011;43(3):309-316.
  10. Maisch B. Alcoholic cardiomyopathy : The result of dosage and individual predisposition. Herz. 2016;41(6):484-493.
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