Recognising Alcoholic Neuropathy

Today's post from nytimes.com (see link below) talks about one of the many cause of neuropathy and that is alcoholism. Many people with other forms of neuropathy will read this article and recognise many of the symptoms - they apply to most neuropathy sufferers, irrespective of the cause. However, alcoholic neuropathy could strike us all, if we drink socially, either moderately or heavily and it is certainly worthwhile knowing what could happen if your drinking gets out of control. If you already have neuropathy, it may be wise to pass on this information to friends and/or family who drink - you wouldn't wish the symptoms on anybody would you?

Alcoholic Neuropathy  
Dr. Mark Willenbring on the challenge of alcohol addiction.

Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.

Dr. Mark Willenbring on the challenge of alcohol addiction.
Also: Recent findings and perspectives on medical research.
Challenging Old Assumptions About Alcoholism
By MARTIN DOWNS 
 
Causes

The exact cause of alcoholic neuropathy is unknown. It likely includes both a direct poisoning of the nerve by the alcohol and the effect of poor nutrition associated with alcoholism. Up to half of long-term heavy alcohol users develop this condition.

In severe cases, nerves that regulate internal body functions (autonomic nerves) may be involved.

Risks of alcoholic neuropathy include:
Long-term, heavy alcohol use
Alcoholism that is present for 10 years or more

Back to TopSymptoms
Numbness in the arms and legs
Abnormal sensations, such as"pins and needles"
Painful sensations in the arms and legs
Muscle weakness
Muscle cramps or muscle aches
Heat intolerance, especially after exercise
Impotence (in men)
Problems urinating, incontinence (leaking urine), feeling of incomplete bladder emptying, difficulty beginning to urinate
Constipation
Diarrhea
Nausea, vomiting

Additional symptoms that may occur with this disease:
Swallowing difficulty
Speech impairment
Loss of muscle function or feeling
Muscle contractions or spasm
Muscle atrophy
Movement disorders

Changes in muscle strength or sensation usually occur on both sides of the body and are more common in the legs than in the arms. Symptoms usually develop gradually and become worse over time. 

Treatment

Once the alcohol problem has been addressed, treatment goals include:
Controlling symptoms
Maximizing ability to function independently
Preventing injury

It is important to supplement the diet with vitamins, including thiamine and folic acid.

Physical therapy and orthopedic appliances (such as splints) may be needed to make sure muscle function and limb position are maintained.

Medicines may be needed to treat pain or uncomfortable sensations. Because persons with alcoholic neuropathy have alcohol dependence problems, they are advised to take the least amount of medicine needed to reduce symptoms to help prevent drug dependence and other side effects of chronic use.

Positioning or the use of a bed frame that keeps the covers off the legs may reduce pain for some people.

Light-headedness or dizziness when standing up (orthostatic hypotension) may require several different treatments before finding one that successfully reduces symptoms. Treatments that may help include:
Wearing compression stockings
Eating extra salt
Sleeping with the head elevated
Using medicines

Bladder problems may be treated with:
Manual expression of urine
Intermittent catheterization (male or female)
Medicines

Impotence, diarrhea, constipation, or other symptoms are treated when necessary. These symptoms often respond poorly to treatment in people with alcoholic neuropathy.

It is important to protect body parts with reduced sensation from injury. This may include:
Checking the temperature of bath water to prevent burns
Changing footwear
Frequently inspecting the feet and shoes to reduce injury caused by pressure or objects in the shoes
Guarding the extremities to prevent injury from pressure

Alcohol must be stopped to prevent the damage from getting worse. Treatment for alcoholism may include counseling or social support such as Alcoholics Anonymous (AA), or taking medicines. 

Prevention

The only way to prevent alcoholic neuropathy is not to drink alcohol.

References

Chopra K, Tiwari V. Alcoholic neuropathy: possible mechanisms and future treatment possibilities. Br J Clin Pharmacol . 2012;73: 348-362.

Katri B, Koontz D. Disorders of the peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice . 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 76.

http://www.nytimes.com/health/guides/disease/alcoholic-neuropathy/overview.html