Because alcohol is the most widely abused drug in our society, there is a prevalence of people with alcohol-related consequences in all treatment settings. Nearly every member of the health care team, across a broad spectrum of places including hospitals, nursing homes, clinics and even homes will be involved with the patient with alcohol-related neurological disease. Acute alcoholic myopathy with myoglobinuria requires monitoring and maintenance of kidney function, and correction of imbalances in blood chemistry including potassium, phosphate, and magnesium levels. Antiepileptic drugs, such as the gamma aminobutyric acid (GABA) analogue (gabapentin), have proven helpful in some cases of neuropathic pain.
No-SAWS vs. SAWS
The most common findings are sensory-related and vary, including pain, numbness, and paresthesias. Pain seems consistent in the literature as 1 of the most common complaints and can be the first clinical indication of the disease. Keeping this disease process high on the differential with the right history is essential. Progression of the disease leads to symmetrical ascending motor and sensory deficits. Alcohol causes neuropathy via multifactorial processes, many of which are still under investigation.
Warning Signs of Alcoholic Neuropathy
The majority of studies which investigate the relationship between malnutrition and neuropathy focus on thiamine deficiency as an aetiological factor, drawing upon existing knowledge of Beri Beri. A smaller number of publications do attribute thiamine deficiency, but generally speaking these studies were older or of lower quality evidence 4, 6, 30, 58, 76, 77. Although alcoholic peripheral neuropathy may contribute to muscle weakness and atrophy by injuring the motor nerves controlling muscle movement, alcoholic neuropathy more commonly affects sensory fibers.
- Deficiencies in these nutrients can harm overall health and prevent nerves from functioning correctly.
- Motor function of the tibial nerve was the next common 3, 11, 51, 54, 59, 63.
- However, severe alcohol-related neuropathy may cause permanent nerve damage.
- The differences in laboratory exams in the NLS vs. ILS group are shown in Table 2.
- A causal but unproven association with ethanol exists, and most cases have no report of thiamine levels.
General Health
- The cerebellum is the part of the brain that controls coordination and balance.
- In chronic myopathy, myoglobinuria is absent, and creatine kinase (CK) is normal, reduced, or mildly elevated, unless an acute myopathy is superimposed.
- Treatment in an appropriately equipped facility is recommended for patients with this risk profile which can be measured easily by a general practitioner or in an emergency department.
- Acetyl-L-carnitine has been tested in clinical 102 and animal studies 103 for the treatment of chemotherapy-induced peripheral neuropathy.
- In many, if not most, cases, improvements in symptoms are seen with continued abstinence from alcohol.
While peripheral neuropathy generally cannot be cured, there are several medical treatments that can be used to manage the pain of alcoholic neuropathy, aiding in your recovery. Yes, alcohol neuropathy long-term excessive alcohol consumption may lead to peripheral neuropathy, which can cause pain in your feet. The diagnosis of alcoholic paralysis depends largely on the practitioner taking a thorough history and finding characteristic symptoms in patients who abuse alcohol.
In chronic alcoholic myopathy, serum creatine kinase often is normal, and muscle biopsy shows atrophy, or loss of muscle fibers. Electromyography (EMG) may show features characteristic of alcoholic myopathy or neuropathy. During alcohol detoxification the brain enters a state of hyperexcitability which may result in alcohol withdrawal syndrome (AWS) with autonomic symptoms like sweating, tremors, anxiety, insomnia, tachycardia, and hypertension. Identifying beforehand which patient will develop AWS or SAWS is a great challenge. Therefore, various tools like the “Prediction of Alcohol Withdrawal Severity Scale” (PAWSS) have been developed 8.
- Human studies have also suggested a direct toxic effect, since a dose-dependent relationship has been observed between severity of neuropathy and total life time dose of ethanol 6, 13.
- You may also benefit from a support group to help you reduce your drinking or completely quit drinking alcohol.
- Pre-existing liver disease, such as alcoholic hepatitis or cirrhosis, can exacerbate nerve damage caused by alcohol.
- The nerves of the extremities may also begin to break down, a condition known as alcoholic peripheral neuropathy, which can add to the person’s difficulty in moving.
There are also direct toxic effects of alcohol and its metabolites on neurons, affecting cellular cytoskeletons and demyelination of neurons. A healthcare professional can offer support for Oxford House people with alcohol use disorder. A doctor may also recommend treatments to manage neurological symptoms, such as pain relief medications, physical therapy, and mobility aids. Alcohol-related neurologic disease refers to a range of conditions caused by alcohol intake that affect the nerves and nervous system. Neurologic disorders can include fetal alcohol syndrome, dementia, and alcoholic neuropathy.
