Alcoholic neuropathy: possible mechanisms and future treatment possibilities

Patients with non-alcoholic thiamine deficiency neuropathy showed more abrupt onset of symptoms, mainly in a form of motor dysfunctions; biopsy showed damage to greater fibers with subperineurial edema. ALN with thiamine deficiency was manifested as a variable mixture of these symptoms. It was proposed that ALN pathogenesis, besides thiamine deficiency itself, could be due to its inappropriate use in the organism or transketolase deficiency [150]. Further, alcohol impairs vitamin B1 absorption and its storage in the liver [151,152,153].

The role of oxidative stress

• Patients who abuse alcohol tend to consume fewer calories and have poor absorption of nutrients in the gastrointestinal tract.
• This study showed that as well as thiamine replacement, corrections of low circulating levels of nicotinic acid, pantothenic acid and vitamin B6 can result in an improvement of alcohol-related peripheral neuropathies.
• The mechanism of direct damage of nerve fibers due to alcohol intoxication remains unclear.

Indirect effects are mainly induced by vitamin deficiencies (B1, B2, B3, B5, B6, B7, B9, and B12) [84, 88]. A review of the human literature implicates nutritional deficiencies, most often thiamine deficiency, that are common in alcoholic patients, as commonly accompanying complicating factors in the development of this neuropathy. Persons with alcoholism may consume smaller amounts of essential nutrients and vitamins and/or exhibit impaired gastrointestinal absorption of these nutrients secondary to the direct effects of alcohol.

Treatment for Alcoholic Neuropathy

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Alcoholic Neuropathy Clinical Presentation

• Other botanical or nutrient therapies include myo-inositol, vitamin E, topical capsaicin, and N-acetylcysteine.
• Alcohol also alters the function of the stomach, liver, and kidneys in ways that prevent the body from properly detoxifying waste material.
• At Healthgrades, our Editorial Team works hard to develop complete, objective and meaningful health information to help people choose the right doctor, right hospital and right care.
• Your doctor will need to rule out other potential causes for your symptoms.
• There is a strong correlation between AAN and Child-Pugh scale which suggests that liver cirrhosis progression is related to impairments in ANS [172].
• These symptoms often respond poorly to treatment in people with alcoholic neuropathy.

Depletion of glutathione increases the susceptibility of neurones to oxidative stress and hyperalgesia [43, 44]. The most impactful treatment in treating alcohol induced neuropathy is abstinence. If you are struggling with alcohol addiction, seeking treatment can prevent the progress of alcoholic neuropathy.

Deficiencies in these nutrients can harm overall health and prevent nerves from functioning correctly. Alcoholic neuropathy can be categorized into different stages based on the progression and severity of nerve damage. The study also found that people in early abstinence showed altered BNST-functional connectivity during unpredictable threat cues, which was dependent on anxiety and sex. Take the following steps if you suspect you have neuropathy from overconsumption of alcohol. Heavy drinkers may experience several health scares, not short of liver failure and severe health implications like ALN. Rather, your treatment program will be built around the goals of controlling your symptoms and preserving your independence for as long as possible.

Clinical symptoms associated with alcoholic peripheral neuropathy

The abnormalities were usually of reduced amplitude, in keeping with axonal loss [2, 3, 5, 11, 12, 16, 21, 27, 37–39, 47, 51, 53, 54, 56, 63–68]. H and F wave latencies were not routinely reported but were found to be prolonged in those with alcohol-related peripheral neuropathy in studies that alcohol neuropathy stages did [4, 67]. Particular attention was paid to radial SNAPs, tibial CMAPs, and sural SNAPs due to them being spared in entrapment neuropathies unlike the median, ulnar, and peroneal nerves. The sural nerve was the most commonly reported nerve [2, 3, 5, 11, 27, 37–39, 51, 53, 59, 63, 68].

Outlook of Alcoholic Neuropathy

It is likely to get worse if the person continues to use alcohol or if nutritional problems are not corrected. Alcoholic neuropathy is usually not life threatening, but it can severely affect quality of life. Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol. The damage may affect the autonomic nerves (those that regulate internal body functions) and the nerves that control movement and sensation. Tricyclic antidepressants (TCAs) are often the first line drugs to alleviate neuropathic pain symptoms.

• PKC and protein kinase A (PKA) are both known to be important in nociceptor function [57–59].
• Intensive research has been done on medications like alpha-lipoic acid, benfotiamine, acetyl-l-carnitine, and methylcobalamin.
• However, neuropathy is generally an exclusion criterion for transplantation.