Alcohol-Induced Neuropathy in Chronic Alcoholism: Causes, Pathophysiology, Diagnosis, and Treatment Options

Abstract

Purpose of the Review 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. Recent Findings Coasting is a major feature of alcoholic neuropathy, largely due to chronic alcohol abuse. Its major features are hyperalgesia, allodynia, and burning pain. Even though much research was done in this area, still we do not have a full understanding of the mechanism of alcoholic neuropathy. However, some theories have been proposed. These include direct or indirect effects of alcohol metabolites, impaired axonal transport, suppressed excitatory nerve pathway activity, or imbalance in neurotransmitters. Activation of spinal cord microglia, mGlu5 spinal cord receptors, and hypothalamic-pituitary-adrenal axis also seem to be implicated in the pathophysiology of this alcoholic neuropathy. The goal of treatment is to impede further damage to the peripheral nerves while also restoring their normal physiology. Alcohol abstinence, intake of balanced diets, and treatment with medications are suggested including benfotiamine, alpha-lipoic acid, acetyl-l-carnitine, vitamin E, methylcobalamin, myo-inositol, N-acetylcysteine, capsaicin, tricyclic antidepressants, or antiepileptic drugs. Summary This review focuses on the many pathways that play a role in the onset and development of alcohol-induced neuropathy, as well as present the possible treatment strategies of this disorder, providing insights into a further search of new treatment modalities.

Etiological profile of peripheral neuropathies in an academic hospital in southern Morocco

“…This is interesting given the religious context in Morocco, where alcohol is prohibited. Alcohol neuropathy is classically a sensory neuropathy due to direct toxicity of alcohol and the implication of nutritional deficiencies associated with alcohol abuse [ 29 ].…”

Toxic and Nutritional Optic Neuropathies—An Updated Mini-Review

“…There is a close association between thiamine deficiency and chronic alcoholism [ 62 ]. It is worth mentioning that thiamine deficiency might induce neuropathy in people who chronically consume excessive amounts of alcohol [ 64 ]. The intestinal absorption of thiamine is diminished by ethanol [ 64 ].…”

“…It is worth mentioning that thiamine deficiency might induce neuropathy in people who chronically consume excessive amounts of alcohol [ 64 ]. The intestinal absorption of thiamine is diminished by ethanol [ 64 ]. The same also reduces the amount of thiamine stored in the liver while also affecting thiamine phosphorylation [ 65 ].…”

“…The same also reduces the amount of thiamine stored in the liver while also affecting thiamine phosphorylation [ 65 ]. Additionally, chronic alcoholics tend to consume very small amounts of vitamins as well as essential nutrients [ 63 , 64 ]. Nutritional absorption by their gastrointestinal tract is also impaired.…”

Adolescent alcohol exposure promotes mechanical allodynia and alters synaptic function at inputs from the basolateral amygdala to the prelimbic cortex

“…However, the dose required for this e ect results in blood alcohol levels akin to binge drinking 3,4 , heightening the risk of alcohol related harm. While acute alcohol consumption can temporarily alleviate pain, chronic misuse promotes hyperalgesia [5][6][7][8][9][10] . Notably, frequent acute pain and pain interference are associated with an elevated risk of being diagnosed with an alcohol use disorder (AUD) [11][12][13] .…”