Alcoholic Neuropathy

The chronic abuse of alcohol can result in neuronal injury. This neuropathy often occurs in both the central and peripheral nervous systems. Symptoms generally include distal paresthesia, weakness, and pain. While the peripheral effects of alcoholic neuropathy can be disabling, the autonomic dysfunction sometimes proves fatal. Moreover, the outcome of this disease may be markedly improved by treatment. Recovering alcoholics suspected of having neuropathy should be encouraged to abstain. Many pathological mechanisms have been proposed for alcoholic neuropathy. While the disease could possibly result from the direct toxic effects of alcohol, nutritional deficiencies are more likely to be responsible. Only through additional research will such questions be answered.

Alcoholism is one of the most common causes of nervous system injury. Chronic consumption of ethanol can cause the development of neuronal damage both centrally and peripherally. In fact, in the Western hemisphere, alcoholic peripheral neuropathy is one of the most common forms of polyneuropathy. Most patients with this disease have a background involving two primary features: severe alcohol abuse extending over several years, and concomitant dietary deficiency. Typically, the disease occurs among individuals between the ages of 40 and 70 years. In addition, alcoholic neuropathy is about six times more common in males than in females.

Despite its widespread occurrence though,

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n performed on chronic alcoholics. As anticipated, most show sensory and motor nerve lesions which tend to be more common distally. Typically, nerve conduction velocities are found to be slowed in the lower limbs; whereas, in severely affected patients, such defects additionally extend to the upper limbs. Alcoholic neuropathy may also be characterized by various central nervous system disorders. For example, some alcoholics exhibit cerebellar impairment. This may be evidenced by poor balance or coordination. The Romberg test measures postural stability. Patients are generally assessed for swaying or unsteadiness. Performance on such tests is highly dependent on cerebellar integrity. Perhaps the most important neuropathy symptoms, however, are those associated with autonomic nerve dysfunction. In general, the parasympathetic nervous system seems to be affected to a greater degree than the sympathetic nervous system. Parasympathetic lesions affecting the vagus nerve can result in depressed heart rate responses to various stimuli. Such lesions may ultimately result in poor exercise tolerance, orthostatic hypotension, and sexual impotence. Lastly, patients may also experience reduced esophageal mobility with dysphagia

Category: Medical - A