Alcoholic Neuropathy: Causes, Effects And Treatment
Neuropathies, or clinical disorders of the nervous system, are a large group of heterogeneous diseases that They affect the nerves responsible for making the body function While some affect the peripheral nervous system, resulting in alterations in motor skills and sensitivity, others attack the autonomic nervous system.
Alcoholic neuropathy, a disorder of the nervous system caused by alcohol consumption, is peripherally affected. Let’s see how nerve damage of alcoholic origin manifests itself.
Alcohol-dependent people suffer marked effects on their nervous system. Almost 10% of alcoholics 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 responsible for sensitivity. Bilateral paresthesias occur in both arms and legs, numbness, tingling sensations 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 eye movement.
Fortunately, the involvement of the autonomic nervous system, which maintains vital functions such as breathing, heart contractions, etc., is mild in this disease The most relevant autonomic 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.
Wernicke’s encephalopathy, which is not exclusive but is particular to alcoholics, consists of inability to move the eyes, difficulty coordinating movements organized and a confused state where the patient is absolutely disoriented. When someone suffers from this disease together with alcoholic neuropathy, we speak of polyneuropathies, since both syndromes coexist.
This is a medical emergency requiring immediate administration of thiamine (vitamin B1). As this symptomatology resolves, the patient begins to show an amnesic condition. 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 events past in time (temporal gaps), confabulation and anterograde amnesia.
Because this pair of syndromes almost always occur together, we speak of a single Wernicke-Korsakoff syndrome, a two-phase disease where the most serious neurological symptoms of the first, when resolved, give way to the amnestic phase. of the second.
Causes of alcoholic neuropathy
Most neurological diseases associated with alcohol consumption have to do with a vitamin deficiency Alcoholic beverages, in addition to inhibiting hunger through their psychoactive characteristics, contain many calories.
The brain, upon receiving the signal that this hypercaloric intake has occurred, interprets that it should not eat more and inhibits the hunger signal. So, the alcoholic feels full even though he has not eaten anything nutritious
Specifically, as in Wernicke-Korsakoff, thiamine plays a crucial role in the development and resolution of the clinical condition.
1. Thiamine deficiency
It is common to find a nutritional deficiency of this vitamin in patients who have chronically abused alcohol, patients who vomit very frequently or patients undergoing bariatric surgery.
Alcoholic neuropathy caused by thiamine deficiency It 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 you will begin to lose sensitivity in your extremities.
Whether it is pure alcoholic neuropathy or accompanied by Wernicke-Korsakoff, this deficit will be resolved with intramuscular or intravenous administration of vitamin B1
2. Pyroxidine deficiency
Although more rare, it is possible that neuropathy is partially caused by the absence of vitamin B6. Both its excess and its absence can cause neurological damage, but in alcohol abuse there is only its deficit. Like thiamine, it can be detected through an analysis.
3. Pellagra
Pellagra is a deficiency of niacin (vitamin B3) 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, Urgent management usually leads to partial recovery, without serious long-term consequences. Depending on the severity of the condition, the person who has suffered the disease will take more or less time to recover.
Nowadays 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 involves withdrawing the consumption of the substance that caused it. To promote recovery, vitamin B supplements are also used, especially B12 and thiamine. As support, it is important to ensure that the patients’ diet is sufficiently nutritious
