Alcohol‐related peripheral neuropathy: Nutritional, toxic, or both?

Abstract

Alcohol-related peripheral neuropathy (ALN) is a potentially debilitating complication of alcoholism that results in sensory, motor, and autonomic dysfunction. Unfortunately, ALN is rarely discussed as a specific disease entity in textbooks because it is widely assumed to primarily reflect consequences of nutritional deficiency. This hypothesis is largely based on observations first made over eight decades ago when it was demonstrated that thiamine deficiency (beriberi) neuropathy was clinically similar to ALN. In recent studies, failure of thiamine treatment to reverse ALN, together with new information demonstrating clinical and electrophysiological distinctions between ALN and nutritional deficiency neuropathies, suggests that alcohol itself may significantly predispose and enhance development of neuropathy in the appropriate clinical setting. We reviewed the evidence on both sides and conclude that ALN should be regarded as a toxic rather than nutritional neuropathy.

Pattern of Peripheral Neuropathy Among Patients With Alcohol Dependence Syndrome

“…[ Studies by Ammandola et al [12] and Mellion et al [18] established significant association between duration of alcohol consumption and cumulative alcohol intake (TLDE) to neuropathy. In the present study, the average duration of alcohol consumption was 17.3 ± 6.6 years.…”

The stiff shoulder; A case study

“…Vitamin B12 deficiency can result in paresthesia, peripheral neuropathy, and demyelination of the corticospinal tract and dorsal columns (Robert and Brown, 2003). The possibility of alcoholic sensory neuropathy was considered as chronic ethanol exposure can cause polyneuropathy characterized by axonal degeneration (Mellion et al, 2011). Recent studies have shown that ethanol exposure has direct neurotoxic effects on peripheral nerves.…”

Neuropathies in malnutrition and alcoholism

“…In recent years the social habits in the western world have changed and food additives may ameliorate the most severe damage. Whether the neuropathy is primarily due to the effect of alcohol, or if it is secondary to nutritional defects accompanying alcoholism has been a source of discussion for a long time [1][2][3][4][5][6][7][8][9][10]. Since some patients with chronic alcoholism and neuropathy do not have a clear nutritional deficiency, and as the neuropathy often does not respond to pure nutritional supplementation, it has become clear that there is also a direct toxic effect of alcohol.…”

“…alcohol related peripheral neuropathy epidemiology The term alcohol-related peripheral neuropathy (ALN) [9] is useful epidemiologically, as it combines both alcohol and neuropathy. The estimated prevalence of neuropathy in patients who suffer from alcoholism, as defined by DSM IV criteria, is between 25 and 66 % in the American population [4,11].…”