Alcohol Ethanol Related Neuropathy Treatment & Management: Medical Care

The percentage of alcohol-dependent patients affected by ALN is estimated to be 66% [50, 51]. The pathophysiology of ALN involves underlying mechanisms that include direct or indirect effects of alcohol metabolites, impaired axonal transport, suppressed excitatory nerve pathway activity, or imbalance in neurotransmitters [52,53,54]. An essential risk factor regarding the etiology of ALN is the amount of alcohol consumed throughout the years since alcohol displays direct toxicity on nerve fibers [55]. It is estimated that consumption of more than 100 ml of ethyl alcohol per day significantly increases the risk of ALN [56]. Recent studies show contradictory information about the role of malnutrition and micronutrients (thiamine) deficiency in the pathogenesis of ALN; however, it is assumed that these might induce the progression of ataxia or movement disorders [55, 57].

What causes alcoholic neuropathy?

However, severe alcohol-related neuropathy may cause permanent nerve damage. However, nerve damage is sometimes permanent, and your symptoms are likely to worsen if you don’t stop drinking. This could lead to disability, chronic pain, and damage to your arms and legs. However, researchers have found that consuming too much alcohol for long periods of time can damage the peripheral nerves. Over time, the effects of drinking too much alcohol may cause alcoholic neuropathy. This condition is also referred to as “alcohol-related neuropathy” to help decrease the stigma surrounding the condition.

• In addition, 32 patients with nonalcoholic thiamine deficiency neuropathy were also evaluated for comparison.
• Treatment is directed toward stopping further damage to the peripheral nerves and returning to normal functioning.
• Professional and peer help through programs such as Alcoholics Anonymous or other substance abuse programs can help you reduce your alcohol consumption.
• The mechanism of this is presently unclear, one possible explanation is that is resolves concomitant vitamin-dependent neuropathy which exacerbates alcohol-related neuropathy.
• Alcoholic neuropathy is nerve damage that results from the toxic effect of alcohol on nerves.

Types and symptoms of alcohol-related neurologic disease

Alcoholic neuropathy is caused by nutritional deficiency, as well as toxins that build up in the body. Alcohol decreases the absorption of nutrients such as magnesium, selenium, and vitamins B1 and B2, causing significant deficits that affect many areas of the body, including the nerves. During the initial stages of ALN, the disease may appear asymptomatic and demonstrable only on electroneurographic investigation [71, 111, 112]. Because ALN is a length-dependent axonopathy, it manifests mainly in a “stocking-glove” form, affecting the lower extremities at the beginning [28, 113]. The main symptoms of ALN include dysesthesia, paresthesia, numbness, and pain in the lower extremities which progressively reach higher parts of the body [114,115,116,117]. The pain is described as burning, cramp-like, or itching; also, a common symptom is a subjective feeling of cold in both feet [118,119,120,121,122,123].

Conditions That May Mimic Alcoholic Neuropathy

This activity describes the evaluation and management of alcoholic neuropathy and reviews the role of the interprofessional team in improving care for patients with this condition. Treatment of ALN aims to reduce further damage to the peripheral nerves and restore their normal functioning. What is crucial during ALN treatment is the alleviation of the major causation of ALN which is alcohol abuse. Alcohol abuse treatment might lead to a resolution of neuropathic pain and alleviation of its symptoms.

• Alcoholic polyneuropathy is a neurological disorder in which peripheral nerves throughout the body malfunction simultaneously.
• The primary aim of this systematic review was to establish the prevalence, character, and risk factors of peripheral neuropathy amongst chronic alcohol abusers and to identify the most appropriate management strategies.
• Once alcohol use has been addressed, a doctor can focus on treating alcohol-related neuropathy itself.
• People who drink heavily on a regular basis are at risk of developing this condition.

Symptoms of AAN are non-specific; in the sympathetic division, these include impairments in perspiration, orthostatic hypotension, whereas in parasympathetic hoarseness, swallowing difficulties, or cardiac arrhythmias [111, 166]. https://ecosoberhouse.com/ Gastrointestinal symptoms include delayed stomach emptying and intestinal transit, dyspepsia, and faster emptying of the gallbladder [165]. Besides, approximately 55% of men with AAN develop erectile dysfunctions [167].

Benfotiamine for the treatment of alcohol related peripheral neuropathy

• Further progression of ALN leads to the weakening of tendon reflexes or total areflexia and disturbed proprioception, which additionally impair the ability to walk [28, 113].
• Nerve damage from chronic alcohol consumption can develop over several years.
• This disease typically occurs in chronic alcoholics who have some sort of nutritional deficiency.
• Ethanol and its toxic metabolites affect neural metabolism including metabolic activities in the nucleus, lysosomes, peroxisomes, endoplasmic reticulum, and cytoplasm [104].

Symptoms can include numbness in hands and feet, digestive issues, and loss of balance due to loss of nerve function. By Heidi Moawad, MDHeidi Moawad is a neurologist and expert in the field of brain health and neurological alcohol neuropathy disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications. The first step in seeking help for alcohol addiction might be to consult your healthcare provider.

According to a 2017 review, muscle myopathy is common in alcohol use disorder. In addition, about 40 to 60 percent of people who experience chronic alcohol misuse also experience alcohol-related myopathy. Researchers have not determined if this is caused by the effects of alcohol on the brain or is the result of thiamine deficiency. Alcoholic neuropathy is progressive damage to peripheral nerves and, in extreme cases, the autonomic nervous system, through chronic, heavy alcohol use. Tricyclic antidepressants (TCAs) are often the first line drugs to alleviate neuropathic pain symptoms.

• In addition, patients with chronic alcoholism tend to consume smaller amounts of essential nutrients and vitamins and/or exhibit impaired gastrointestinal absorption of these nutrients secondary to the direct effects of alcohol.
• Alcoholic neuropathy is usually not life threatening, but it can severely affect quality of life.
• However, stopping consuming alcohol sooner can help stop the progression of nerve damage.
• Female mouse with injected testosterone showed the decreased activity of cytosolic isoform of ALDH which implies that those enzymes are sensitive to estrogen and testosterone and alcohol metabolism is greater in females.
• These individuals draw the majority of calories from calorie rich alcoholic beverages with low nutritive value.

Oxidative-nitrosative stress and alcoholic neuropathy

Recently, extended release gabapentin relieved symptoms of painful polyneuropathy [120]. Lamotrigine was effective in relieving central post stroke pain [121] and painful diabetic polyneuropathy [122], but recent larger studies have failed to show a pain relieving effect in mixed neuropathic pain [123] and painful polyneuropathy [124]. Valproate demonstrated varying effects in different studies of neuropathic pain, with three studies from one group reporting high efficacy [125–127] and others failing to find an effect [128, 129].

Direct toxic effects of ethanol or its metabolites (direct toxicity)