Alcoholic Neuropathy: Causes, Symptoms, Treatment, & Prevention

Not being able to tell when things are too hot because of the way the nerve damage interferes with the ability to sense temperature changes can make one more susceptible to burns. In the same manner, numbness and lowered ability to feel pain sensations can make people more apt to cut themselves or otherwise damage the skin. Often, individuals may not even realize that they are burned or cut because they just don’t feel it, which can elevate the risk for infection. Primarily, it was assumed that the progression of ALN symptoms is due to malnutrition and micronutrient deficiency (mainly B1 hypovitaminosis) 82, 83. Indeed, these factors contribute to the progression of ALN symptoms; however, they do not constitute direct factors that manifest in ALN development 84.

Role of caspases in alcoholic neuropathy

Reduced glutathione is a major low molecular weight scavenger of free radicals in cytoplasm. Depletion of glutathione increases the susceptibility of neurones to oxidative stress and hyperalgesia 43, 44. Alcoholic polyneuropathy is progressive and gets worse over time, as the damage to the nerves increases with continued alcohol abuse. The problems that alcoholic neuropathy causes with muscle weakness, balance, and coordination can make a person more at risk for falling down and getting injured.

People can successfully regulate their drinking habits and abstain from alcohol at an inpatient facility. However, folate or B12 shortage can occur when you don’t get enough vitamins and minerals from your usual diet. Chronic alcohol usage can also lead to inflammation and oxidative stress in the body. Axonal degeneration and demyelination, or damage to the myelin surrounding the nerves, are linked to this. Thus, treatment with anticonvulsant drugs may provide another therapeutic alternative for the symptomatic relief of pain in patients with alcoholic neuropathy. Therefore, topical application with capsaicin may provide symptomatic relief from neuropathic pain in patients suffering from alcoholic neuropathy.

The severity of the neuropathy and the person’s past alcohol use both have an impact on how long it takes to recover from alcoholic neuropathy, which varies greatly from person to person. If they stop drinking and get the right help right once, those with moderate neuropathic symptoms and a shorter history of alcohol misuse may recover more quickly and significantly. However, those who have a long history of heavy alcohol consumption and more severe neuropathy may find it more difficult to recover, and if nerve damage is severe, some symptoms might become permanent. Alcohol causes neuropathy via multifactorial processes, many of which are still under investigation.

Losing weight is a prodrome, especially in persistent alcoholics (early warning symptom) of the potential development of alcoholic polyneuropathy since it typically indicates a nutritional shortage that might cause the disease to develop. Antiepileptic drugs, such as the gamma aminobutyric acid (GABA) analogue (gabapentin), have proven helpful in some cases of neuropathic pain. These drugs have central and peripheral anticholinergic effects, as well as sedative effects, and they block the active re-uptake of norepinephrine and serotonin.

• There are also direct toxic effects of alcohol and its metabolites on neurons, affecting cellular cytoskeletons and demyelination of neurons.
• By Heidi Moawad, MDHeidi Moawad is a neurologist and expert in the field of brain health and neurological disorders.
• The first step for addressing alcohol-related neuropathy is to go through alcohol rehab or otherwise stop drinking.
• Other causes can lead to neuropathy besides alcohol, so your healthcare provider may order additional tests to confirm what has caused your symptoms.

Alcohol enters the bloodstream from the digestive system within 5 minutes of consumption, and peak absorption is seen within 30 to 90 minutes. Patients who abuse alcohol tend to consume fewer calories and have poor absorption of nutrients in the gastrointestinal tract. There are also direct toxic effects of alcohol and its metabolites on neurons, affecting cellular cytoskeletons and demyelination of neurons.

• Acetaldehyde dehydrogenase is a mitochondrial enzyme which undergoes a single amino acid substitution (mutation) in about 50% of the Asian population in a way similar to the genetic changes in sickle cell anaemia 21.
• Chronic alcohol usage can also lead to inflammation and oxidative stress in the body.
• Recently findings from our laboratory also suggest the benefecial effects of both α-tocopherol and tocotrienol, isoforms of vitamin E, in the prevention of hyperalgesia and allodynia in rats administered ethanol for 10 weeks 55.
• Alcoholic neuropathy can result in hypersensitivity to touch and even resting pain.
• Thus, further preclinical and clinical studies are required to assess of this molecule in alcoholic neuropathy.

Having a healthcare professional come to your house to assist with your needs can relieve a lot of added stress on you to keep track of your treatment plan alone. Nerve damage typically affects the axons, which are the projections that send electrical signals from one nerve to another. It also impacts the myelin, which is the fatty coating that protects the nerves. Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Reframe supports you in reducing alcohol consumption and enhancing your well-being.

A connection between MEK/ERK signaling and alcoholic neuropathy

The serotonin/norepinephrine re-uptake inhibitors (SNRIs), duloxetine and venlafaxine, have a well-documented efficacy in painful polyneuropathy 117, 118. SSRIs have been studied in a few trials which have demonstrated a weak analgesic effect but the clinical relevance of these compounds is questionable 119. A person who drinks alcohol excessively may start to feel a tingling sensation in their limbs. This condition is typically not life-threatening, but the nerve damage from alcoholic neuropathy is usually permanent. Further, ECG changes and functions of the digestive tract (dyspeptic symptoms, stomach and gallbladder motility, orocecal transit time) can also be assessed 162, 165.

• Poor absorption and low intake of these vitamins have clinical features of dermatitis, neuropathy, and anorexia.
• Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.
• Many alcohol rehab programs help to manage co-occurring disorders, such as alcoholic polyneuropathy.
• Western immunoblot analysis indicated a higher level of PKCε in dorsal root ganglia from alcohol-fed rats, supporting a role for enhanced PKCε second messenger signalling in nociceptors contributing to alcohol-induced hyperalgesia 16.
• Other coexisting, alcohol-related diseases may induce exacerbation of AAN symptoms.
• To try to address the long-term consequences of alcohol on the liver, this treatment is also necessary.

Alcohol Abuse Diagnostic Criteria and Biomarkers

Thus, deficiency of these vitamins was felt to be unlikely in Danish beer drinkers at that time and, indeed, measured vitamin concentrations were mostly normal. Clinical features of neuropathies in the alcoholic and post gastrectomy patients were similar. These two groups, however, were distinct from the standpoint that nerve conduction velocities were slower and sural nerve biopsy specimens revealed more segmental demyelination in the post gastrectomy group. The authors concluded that malnutrition, including low blood concentrations of B vitamins, is not a prerequisite for the development of alcoholic neuropathy, and ethanol per se plays a role in the pathogenesis of alcoholic neuropathy.

Electromyography (EMG) and nerve conduction studies (NCV):

Some of the most common symptoms are numbness or tingling sensation in the extremities, pain or a burning sensation in the extremities, difficulty walking, difficulty urinating, and difficulty talking or swallowing. Heavy drinkers may experience several health scares, not short of liver failure and severe health implications like ALN. It is important to supplement the diet with vitamins, including thiamine and folic acid. Especially if you have been drinking heavily for many years, coping with alcohol use disorder is not easy.

Another prominent effect of alcoholic neuropathy involves painful and uncomfortable sensations. Alcoholic neuropathy can result in hypersensitivity to touch and even resting pain. Light touch can feel exaggerated and painful, particularly in the fingers and toes. Halfway house The psychological impact of chronic conditions such as alcoholic neuropathy should not be underestimated.

Alcoholic Neuropathy: Symptoms, Treatment, and Recovery Timelines

These relationships make chronic alcoholism a risk factor for thiamine deficiency. 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.

Decreased Sensation

Alcohol abuse affects the peripheral and the central nervous system adversely. A common adverse effect of chronic alcohol consumption is alcohol neuropathy. We do not know precisely how many people are affected by alcohol neuropathy, but research has shown that at least 66% of chronic alcohol abusers may have some form of neuropathy. Neuropathy has multifactorial causes, ranging from nutritional deficiencies to the toxic effects that alcohol has on neurons. Because of the many effects that alcohol has on the organism, it is important that patients with alcoholic neuropathy be managed by a team of inter-professionals in the health industry. However, there is poor compliance on the part of patients, resulting in the progression of the condition and ultimately, poor quality of life.