Alcohol-related peripheral neuropathy: a systematic review and meta-analysis PMC

Another prominent effect of alcoholic neuropathy involves painful and uncomfortable sensations. Alcoholic neuropathy can result in hypersensitivity to touch and even resting pain. Light touch can feel exaggerated and painful, particularly in the fingers and toes. People with a lengthy history of alcohol misuse might experience loss of balance, pain, tingling, weakness, or numbness after drinking alcohol.

Alcoholic Neuropathy Symptoms

Risks for the baby can include brain damage and developmental, cognitive, and behavioral issues. No amount of alcohol is safe to drink while pregnant, according to the CDC. Alcohol withdrawal syndrome occurs when someone who has been drinking excessive amounts of alcohol for an extended period of time suddenly stops drinking or reduces their intake.

Management of alcohol-induced peripheral neuropathy

Female mouse with injected testosterone showed the decreased activity of cytosolic isoform of ALDH which implies that those enzymes are sensitive to estrogen and testosterone and alcohol metabolism is greater in females. Alcoholic polyneuropathy is a neurological disorder in which peripheral nerves throughout the body malfunction simultaneously. It is defined by axonal degeneration in neurons of both the sensory and motor systems and initially occurs at the distal ends of the longest axons in the body. This nerve damage causes an individual to experience pain and motor weakness, first in the feet and hands and then progressing centrally.

Peripheral neuropathy

Axons are encased by myelin—the fatty connective tissue that accelerates the rate of electrical impulses through neurons. Neuron injury may occur when the axon is directly damaged, there are conduction disturbances through the nerve, or there’s demyelination of nerve cells. The neurotoxic effects of alcohol or one of its metabolites and vitamin deficiencies cause axonal injury by decreasing nerve fiber density, leading to painful PN and motor and autonomic dysfunction.

• The most important risk factor for alcohol-related peripheral neuropathy is the total lifetime dose of ethanol, although other risk factors have been identified including genetic, male gender, and type of alcohol consumed.
• Even if your loved one seeks help, you may still need help and support to overcome the effects.
• The term polyneuropathy is used when multiple peripheral nerves are damaged.
• Likewise, thermal sensitivity alterations are common in neuropathic patients and easily evaluated in animal models.

Apoptosis of neurones was induced by cisplatin, but pre-incubation with N-acetylcysteine completely blocked apoptosis [112]. In addition, a support group can help you cope with the life changes you’re experiencing as a result of your condition. You might look for a support group specifically for alcoholic neuropathy or for people coping with chronic pain. You may also benefit from a support group to help you reduce your drinking or completely quit drinking alcohol. While peripheral neuropathy generally cannot be cured, there are several medical treatments that can be used to manage the pain of alcoholic neuropathy, aiding in your recovery.

Acetaldehyde

Acetaldehyde dehydrogenase is a mitochondrial enzyme which undergoes a single amino acid substitution (mutation) in about 50% of the Asian population in a way similar to the genetic changes in sickle cell anaemia [21]. Thus, in alcoholics with the mutated dehydrogenase enzyme, acetaldehyde concentrations may reach values about 20 times higher than in individuals without the mutation. A certain amount of acetaldehyde is not metabolized by the usual pathways (Figure 2) and binds irreversibly to proteins which results in the creation of cytotoxic proteins which adversely affect the function of nervous system cells. These abnormal proteins influence other cell populations especially the hepatocytes where the damage to hepatic mitochondria results in hepatic cirrhosis with reduction of energetic substrates in the liver. The action of these abnormal proteins is explained by competition with normal proteins causing the damage to function and metabolism of the cell [22].

• Several mGluR subtypes have been identified in the superficial dorsal horn of the spinal cord [76, 77] and on primary afferent fibres [78].
• Elevated levels of the liver enzymes gamma-glutamyl transpeptidase, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase may indicate long-standing heavy alcohol consumption and its effects on hepatic function.
• It is estimated that in the United States 25% to 66% of chronic alcohol users experience some form of neuropathy; however, the true incidence in the general population is unknown.
• These findings support the idea that the increased number of membrane-bound mGluR5 following chronic ethanol consumption may lead to a long lasting activation of neuronal protein kinase C in the dorsal horn of the spinal cord.

CRediT authorship contribution statement

To evaluate the peripheral nervous system for primary neurologic pathology or secondary systemic disorders, electrodiagnostic testing consists of nerve conduction studies to measure nerve conduction and an electromyogram (EMG) to measure muscle conduction. Autonomic nerve damage may cause a fluctuation in heart rate and BP, leading to orthostatic hypotension. Patients are likely to experience heat intolerance, excessive sweating, difficulty while swallowing, nausea, diarrhea, and constipation. Sexual drive and performance are diminished in both men and women, including erectile dysfunction in men. Nerve degeneration progresses from sensory symptoms to include motor function problems of the lower and upper extremities.

ALN and Gender

Damage to nerves caused by alcoholic neuropathy, however, is usually permanent. Steven Collier RN is one of the co founders of the Hemet Valley Recovery Center and owner of Addiction Medicine Services Inc. He has been working in the behavioral health field since serving as a command Drug Exemption Officer in the U.S. A graduate of California State University Los Angeles, Mr. Collier holds a BA in Health and Safety Studies as well as a certificate as a specialist in Drug and Alcohol Problems also from Cal State.

Functional Observational Battery (FOB)

A skin biopsy of the sural nerve may be conducted and will initially show small fiber neuropathy, which results from injury to nerve fibers that may be myelinated or unmyelinated. Injury to these small nerve fibers leads to somatic and alcohol neuropathy stages autonomic symptoms. Allodynia—when pain is experienced by a stimulus that wouldn’t normally cause pain—may be present in small fiber neuropathy. For example, a patient experiences pain or other dysesthesias when putting on socks.