Alcoholic neuropathy

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Definition

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

Alternative Names

Neuropathy - alcoholic; Alcoholic polyneuropathy

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

Symptoms

Symptoms of this condition include any of the following:

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.

Exams and Tests

The health care provider will perform a physical exam and ask about symptoms. An eye exam may show eye problems.

Alcoholism often makes the body unable to use or store certain vitamins and minerals. Blood tests will be ordered to check for a deficiency (lack) of:

Other tests may be ordered to rule out other possible causes of neuropathy. Tests may include:

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 maintain muscle function and limb position.

Medicines may be needed to treat pain or uncomfortable sensations. People with alcoholic neuropathy have alcohol use problems. They will be prescribed the smallest dose 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 help reduce pain.

People with lightheadedness or dizziness when standing up (orthostatic hypotension) may need to try several different treatments before finding one that successfully reduces their symptoms. Treatments that may help include:

Bladder problems may be treated with:

  • Manual expression of urine
  • Intermittent catheterization ( or )
  • 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, social support such as Alcoholics Anonymous (AA), or medicines.

Outlook (Prognosis)

Damage to nerves from alcoholic neuropathy is usually permanent. 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.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have symptoms of alcoholic neuropathy.

Prevention

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

References

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.

Koppel BS. Nutritional and alcohol-related alcoholic disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 416.

Version Info

  • Last reviewed on 6/1/2015
  • Daniel Kantor, MD, Kantor Neurology, Coconut Creek, FL and Immediate Past President of the Florida Society of Neurology (FSN). Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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