Alcoholic Neuropathy: Causes, Effects, and Treatment

Neuropathies, or clinical disorders of the nervous system, are a large group of heterogeneous diseases that affect the nerves that make the body work. While some affect the peripheral nervous system, resulting in motor and sensitivity disorders, others attack the autonomic nervous system.

Alcoholic neuropathy, a nervous system disorder caused by alcohol useIt is peripherally affected. Let's see how nervous damage of alcoholic origin manifests itself.

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Clinic in alcoholic neuropathy

People dependent on alcohol suffer accentuated effects on their nervous system. Almost 10% of alcoholics who consume high doses of ethanol chronically they end up suffering from alcoholic neuropathy in some of its forms.

These patients with alcoholic neuropathy suffer damage to the axons of neurons motor and those in charge of sensation. Bilateral paresthesias occur in both arms and legs, numbness, a tingling sensation, and paresthesias, which are more accentuated in the hands and feet. In addition, gait and posture disorders may occur due to degeneration or atrophy of the cerebellum, as well as nystagmus, a brief, involuntary movement of the eyes.

Fortunately, the affectation of the autonomic nervous system, which maintains vital functions such as breathing, heart contractions, etc., it is mild in this disease. The most relevant autonomous symptom is the inability to have an erection and maintain it, that is, impotence. However, there are autonomous symptoms when alcoholic neuropathy is accompanied by a characteristic syndrome of alcohol-dependent people: Wernicke's disease.

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Wernicke's encephalopathy

Wernicke's encephalopathy, which is not exclusive but is particular to alcoholics, consists of the inability to move the eyes, difficulty coordinating movements organized and a confusional state where the patient is completely disoriented. When someone suffers from this disease together with alcoholic neuropathy, we speak of polyneuropathies, since both syndromes coexist.

It is a medical emergency requiring immediate administration of thiamine (vitamin B1). As these symptoms resolve, the patient begins to show amnesic symptoms. It's Korsakoff's psychosis.

Korsakoff syndrome

The second phase of this syndrome is called Korsakoff psychosis. It is characterized by the inability to remember past events in time (temporary gaps), collusion and anterograde amnesia.

Because this pair of syndromes almost always occurs together, we speak of a single Wernicke-Korsakoff syndrome, a two-phase disease where the more severe neurological symptoms of the first, when resolved, give way to the amnesic phase of the second.

• Related article: "Wernicke-Korsakoff syndrome: causes and symptoms"

Causes of alcoholic neuropathy

Most alcohol-associated neurological diseases have to do with a vitamin deficiency. Alcoholic beverages, in addition to inhibiting hunger through their psychoactive characteristics, contain a lot of calories.

The brain, upon receiving the signal that this hypercaloric contribution has occurred, interprets that it should not eat more and inhibits the hunger signal. So, the alcoholic feels satiated despite not having eaten anything nutritious.

Specifically, as in Wernicke-Korsakoff, thiamine plays a crucial role in the development and resolution of the clinical picture.

1. thiamine deficiency

It is common to find a nutritional deficit of this vitamin in patients who have abused alcohol chronically, patients who vomit very frequently or patients undergoing surgery bariatric.

Alcoholic neuropathy caused by thiamine deficiency begins after having deprived the body of this vitamin for a long time. It begins with a mild loss of sensation, subtle burning sensations in the toes, and leg cramps. Later on, the sensitivity of the extremities will begin to be lost.

Whether it is a pure alcoholic neuropathy or accompanied by Wernicke-Korsakoff, this deficit will be resolved with the intramuscular or intravenous administration of vitamin B1.

2. pyroxidine deficiency

Although rarer, neuropathy may be partially caused by a lack of vitamin B6. Both its excess and its absence can cause neurological damage., but in alcohol abuse is only its deficit. Like thiamine, it can be detected through an analysis.

3. Pellagra

Pellagra is niacin (vitamin B3) deficiency due to malnutrition or alcoholism. The neurological manifestations are variable: they affect the central nervous system and also the peripheral nerves.

Forecast

Alcoholic neuropathy is a severe neurological disease that must be treated immediately. Fortunately, its urgent management usually leads to a partial recovery, without serious long-term sequelae. Depending on the severity of the condition, the person who has suffered the disease will take more or less time to recover.

Today it is possible to make an accurate diagnosis of alcoholic neuropathy through analysis to detect vitamin deficiencies and electrodiagnostic nerve conduction tests and electromyograms. In this way the treatment can be administered quickly and effectively for a complete recovery.

Treatment

Medical intervention in cases of alcoholic neuropathy always requires withdrawal from the consumption of the substance that produced it. To promote recovery, in addition, vitamin B supplements are used, especially B12 and thiamine. As support, it is important to make sure that the patients' diet is nutritious enough.