Alcoholic Neuropathy: Causes, Symptoms, and Diagnosis

neuropathy and alcohol

Most patients with SFN experience a slowly progressive course, with a clinical plateau reached following years of symptom development. It additionally found that over half of the patients either improved or remained stable over the 2 years. Further studies would be useful in evaluating symptomatic progression over a period longer than 2 years. Symptoms may be mild at onset, with some patients noting a vague foot discomfort. Reported descriptions may include numbness in the toes, a wooden quality in the feet, or a feeling the patient describes as walking on sand, golf balls, or pebbles. Burning pain in the feet, expanding proximally in a stocking-glove distribution, is often the most bothersome and typical symptom.

Connect with UF Health

However, the limitations of those studies include the lack of the possibility to measure the amount of vitamin B1 in the serum; further, patients who were involved in the study have received an unrefined form of the supplement. Later, the results have been supported by Victor and Adams (1961)—among 12 patients with ALN, neuropathic symptoms were alleviated just after thiamine supplementation, even though the alcohol consumption was previously completely reduced 149. Koike et al. (2003) compared clinical and histological differences between ALN with and without thiamine deficiency 65. Also, the results of the group of 32 patients with non-alcoholic thiamine deficiency neuropathy were considered. Thiamine deficiency resulted in the progression of sensory dysfunctions; further, histological examination of the sural nerves revealed the loss of small nerve fibers and segmental demyelination. Patients with non-alcoholic thiamine deficiency neuropathy showed more abrupt onset of symptoms, mainly in a form of motor dysfunctions; biopsy showed damage to greater fibers with subperineurial edema.

Product Reviews

It is likely to get worse if the person continues to use alcohol or if nutritional problems are not corrected. Alcoholic neuropathy is usually not life threatening, but it can severely affect quality of life. Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol. The damage may affect the autonomic Substance abuse nerves (those that regulate internal body functions) and the nerves that control movement and sensation.

neuropathy and alcohol

Conditions That May Mimic Alcoholic Neuropathy

Accurate diagnosis is important since these conditions are often treatable and preventable. This article reviews the key features of different types of neuropathies caused by these etiologies and provides a comprehensive list of specific agents that must be kept in mind. Because the symptoms of alcoholic neuropathy can be similar to those of other neuropathy and alcohol conditions, your doctor may first rule out other possible causes of your symptoms.

Activation of spinal cord microglia, mGlu5 spinal cord receptors, and hypothalamic-pituitary-adrenal axis appear to be implicated in this process 92,93,94,95,96,97.
If your doctor confirms a diagnosis of alcoholic neuropathy, they will discuss treatment options, including help for alcohol use disorder.
The cause is multifactorial, from both nutritional deficiencies and alcohol metabolism’s direct toxic effects on neurons.
The decreases in nerve conduction velocity were significantly less in groups supplemented with acetyl-L-carnitine.
These are some other questions people often ask about alcoholic neuropathy.

Is alcoholic neuropathy fatal?

Lee et al. 36 suggested that reactive oxygen species are importantly involved in the development and maintenance of capsaicin-induced pain, particularly in the process of central sensitization in the spinal cord in rats.
A systematic review suggests that 46.3% of people who engage in chronic heavy alcohol use have alcoholic neuropathy.
8, 9 Acetaldehyde, a metabolite of ethanol (ETOH), has a direct neurotoxic effect.
Reflexes were brisk at the knees and reduced at the ankles, and Babinski sign was present bilaterally.
A person should speak with a doctor if they are experiencing any symptoms of alcoholic neuropathy or if they are concerned about their alcohol use.
They will be prescribed the smallest dose of medicine needed to reduce symptoms.

If you are ready to learn more about addiction treatment, American Addiction Centers (AAC) is ready to help. AAC is a leading provider of evidence-based addiction treatment with facilities across the U.S. You can call our free, confidential helpline at for more information about rehab.

neuropathy and alcohol

Thus, these vitamin deficiencies were not considered to be major causal factors of neuropathy 26.
A systematic, computer-based search was conducted using the PubMed database.
Thiamine serves as an important coenzyme in carbohydrate metabolism and neuron development.
18, 19 Alcohol also has been implicated in the development of cardiac autonomic neuropathy (CAN) and various cranial neuropathies, including optic neuropathy and vagus neuropathy.
26 This study used the sural sensory nerve action potential (SNAP) amplitude (ie, nerve conduction study) as the variable measure to detect significant neuropathy in a population of males and females with chronic alcoholism.

In addition to thiamine deficiency, recent studies indicate a direct neurotoxic effect of ethanol or its metabolites. Axonal degeneration has been documented in rats receiving ethanol while maintaining normal thiamine status 5. 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. The exact mechanism behind alcoholic neuropathy is not well understood, but several explanations have been proposed. Some other studies have indicated that chronic alcohol intake can decrease the nociceptive threshold with increased oxidative-nitrosative stress and release of pro-inflammatory cytokines coupled with activation of protein kinase C (Figure 1) 10, 16. Therefore, alcoholic neuropathy may occur by a combination of the direct toxic effects of ethanol or its metabolites and nutritional deficiencies, including thiamine deficiency.

Oxidative-nitrosative stress and alcoholic neuropathy

On EMG, long-duration motor unit potentials were observed in distal musculature. The study was interpreted as consistent with an axonal sensorimotor peripheral neuropathy. Alcohol abuse causes a wide range of disorders that affect the nervous system. These include confusion, cerebellar ataxia, peripheral neuropathy, and cognitive impairment. Chronic and excessive alcohol consumption is the primary cause of peripheral neuropathy. It is worth noting that peripheral neuropathy has no reliable treatment due to the poor understanding of its pathology.

Prevalence

People who struggle with alcoholism should try to eat a healthy and balanced diet, even if they don’t feel hungry. In a 2019 study, researchers showed that quitting alcohol had a positive effect on most people’s mental well-being. Completely avoiding alcohol and eating a balanced diet can help minimize damage.