Alcoholic Neuropathy

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Introduction

What is alcoholic neuropathy?

Alcoholic neuropathy is a disease associated with chronic alcohol abuse that is characterized by damage to the nervous system. Alcoholic neuropathy can affect the brain as well as nerves situated anywhere in the body including the feet, hands, muscles, gastrointestinal system, and reproductive system. Although the exact cause of alcoholic neuropathy is not known, it is thought to result from alcohol-related nerve damage, as well as poor diet and vitamin deficiency, which are associated with excessive drinking.

Signs and symptoms of alcoholic neuropathy can develop over a long period of time and include sensations of numbness, tingling and pain, as well as muscle weakness. Muscle weakness is more frequently experienced in the legs but can also occur in the arms and other regions of the body.

Successful management of alcoholic neuropathy begins with addressing the alcohol problem. Dietary supplementation, especially with B vitamins, which are essential for proper nerve function, can help improve symptoms. Pain-relieving medications are another treatment option. Left untreated, alcoholic neuropathy may lead to permanent nerve damage, loss of sensation, and chronic pain.

Seek immediate medical care for serious symptoms, such as numbness or tingling in your legs or arms, loss of bladder or bowel control, muscle spasms, muscle weakness, and speech impairment. Seek prompt medical care if you are being treated for alcoholic neuropathy but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of alcoholic neuropathy?

Alcoholic neuropathy may result in a number of symptoms, all of which are related to nerve damage and can vary in intensity. Symptoms of muscle weakness and sensitivity to touch typically develop on both sides of the body. These symptoms occur more often in the legs than in the arms and gradually become worse over time.

Common symptoms of alcoholic neuropathy

You may experience alcoholic neuropathy symptoms daily or just once in a while. At times any of these nerve symptoms can be severe and will depend on the nerves affected:

  • Altered thinking and decision-making (poor cognition)
  • Impaired coordination
  • Muscle weakness
  • Nausea with or without vomiting
  • Numbness or tingling in legs or arms
  • Pain in arms and legs
  • Visual disturbances (decreased vision, double vision, etc.)

    Symptoms that might indicate a serious condition

    In some cases, alcoholic neuropathy can be a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care if you, or someone you are with, have any of these serious symptoms including:

    • Confusion or loss of consciousness for even a brief moment
    • Fainting or change in level of consciousness or lethargy
    • Severe pain
    • Severe weakness
    Causes

    What causes alcoholic neuropathy?

    Alcoholic neuropathy is a disease characterized by impaired nerve function caused by excessive drinking of alcohol and nutritional deficits related to alcohol abuse. Individuals who have suffered from alcoholism for 10 or more years or who drink excessive amounts of alcohol regularly have a high risk of alcoholic neuropathy.

    Alcoholic neuropathy is caused by multiple factors. Alcohol can have a direct toxic effect on the nerves, resulting in nerve damage and dysfunction. Alcohol abuse also decreases the body’s ability to absorb nutrients that are essential for proper nerve functioning. Finally, people who abuse alcohol also tend to have poor nutritional intake, which can also contribute to nerve damage.

    What are the risk factors for alcoholic neuropathy?

    A number of factors increase the risk of developing alcoholic neuropathy. Not all people with risk factors will get alcoholic neuropathy. Risk factors for alcoholic neuropathy include:

    Reducing your risk of alcoholic neuropathy

    You may be able to lower your risk of alcoholic neuropathy by:

    • Eating a healthy diet

    • Limiting alcohol consumption to two drinks per day if you are a male, and one drink a day if you are female

    • Taking a multivitamin supplement, especially if you drink alcohol

    • Treating an alcohol problem

    Treatments

    How is alcoholic neuropathy treated?

    Treatment for alcoholic neuropathy begins with seeking medical care from your health care provider and addressing any alcohol problem you may have.

    Vitamin supplementation treatments for alcoholic neuropathy

    Vitamin supplementation and medications to reduce pain and discomfort are the mainstays of treatment for alcoholic neuropathy. If you have alcoholic neuropathy, supplementation with the following vitamins may improve symptoms:

    • Biotin
    • Folic acid
    • Vitamin A
    • Vitamin B1 (thiamine)
    • Vitamin B3 (niacin)
    • Vitamin B5 (pantothenic acid)
    • Vitamin B6 (pyridoxine)
    • Vitamin B12 (cobalamin)
    • Vitamin E (tocopherol)

    Pain control medications for alcoholic neuropathy

    Your health care provider may recommend prescription pain medications. Antiseizure medications that are effective in the treatment of nerve pain resulting from alcoholic neuropathy include:

    • Carbamazepine (Tegretol)
    • Gabapentin (Neurontin)
    • Phenytoin (Dilantin)
    • Pregabalin (Lyrica)
    • Topiramate (Topamax)

    Medications containing opiates, such as codeine, that are physically addicting and may lead to dependence will be prescribed only when other options are not successful in relieving severe pain. Additional options to treat nerve pain associated with alcoholic neuropathy include antidepressants, such as amitriptyline (Elavil), nortriptyline (Pamelor), and duloxetine (Cymbalta).

    What you can do to relieve pain caused by alcoholic neuropathy

    In addition to following the treatment plan you and your health care professional determine is best for you, you can improve your symptoms by:

    • Changing position to reduce pain

    • Following a healthy diet to improve nutrition

    • Getting a foot and hand massage

    • Maintaining footwear to avoid injuries due to reduced feeling in feet

    • Stopping alcohol use

    What are the potential complications of alcoholic neuropathy?

    Complications of untreated alcoholic neuropathy can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of alcoholic neuropathy include:

    • Disability
    • Impaired coordination
    • Permanent loss of sensation
    • Permanent nerve damage
    • Permanent or chronic pain
    • Progressive, irreversible dementia
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    Medical Reviewer: William C. Lloyd III, MD, FACS
    Last Review Date: 2018 Nov 12
    1. Alcoholic neuropathy. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001733/.
    2. Alcoholism and alcohol abuse. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001940/.
    3. Claus D, Eggers R, Engelhardt A, et al. Ethanol and polyneuropathy. Acta Neurol Scand 1985; 72:312.
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