Alcoholic neuropathy: possible mechanisms and future treatment possibilities PMC
Deficiencies in B6 and B12, thiamine, folate, niacin, and vitamin E can make it worse. Alcohol-related neurologic disease refers to a range of conditions caused by alcohol intake that affect the nerves and nervous system. Neurologic disorders can include fetal alcohol syndrome, dementia, and alcoholic neuropathy. Acetyl-L-carnitine has been tested in clinical [102] and animal studies [103] for the treatment of chemotherapy-induced peripheral neuropathy.
- Endoneural oxidative stress leads to nerve dysfunction in rats with chronic constriction injury [39].
- Your health care provider will perform a physical exam and ask about symptoms.
- They have central effects on pain transmission and block the active re-uptake of norepinephrine and serotonin.
- By scanning the reference lists of included studies, an additional 4 papers were identified.
- Alternative therapies like chiropractic care, body manipulation, acupuncture, meditation, and massage therapy can be helpful in managing pain and symptoms of alcoholic polyneuropathy.
- Reduced recruitment pattern of motor units was a frequently reported outcome [16, 28, 67, 70].
Effects due to nutritional deficiency
Alcohol abuse contributes to peripheral neuropathy development involving both somatic and autonomic nerves [154, 155]. However, impairments of autonomic functions are scarcer and less intensified, and, usually, clinical symptoms are delayed [156]. According to many studies, alcohol-induced autonomic neuropathy (AAN) not only leads to potential damage to internal organs but also increases the mortality rate of patients [157, 158]. It was observed that abstinence may lead to the regression of several symptoms of AAN [159]. If you have a diagnosis of alcoholic neuropathy, abstinence from alcohol is the primary treatment to restore nerve function.
Peripheral neuropathy causes
In agreement with this, one recent study has confirmed the efficacy of TCAs in central pain [116]. The serotonin/norepinephrine re-uptake inhibitors (SNRIs), duloxetine and venlafaxine, have a well-documented efficacy in painful polyneuropathy [117, 118]. SSRIs have been studied in a few trials which have demonstrated a weak analgesic effect but the clinical relevance of these compounds is questionable [119]. 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.
Alcohol-related peripheral neuropathy: a systematic review and meta-analysis
The demyelination is explained as the result of a slowing down (decceleration) of axoplasmic flow and a degradation of the quality of biological properties of axonal enzymes and proteins. This type of degeneration, so called ‘dying-back’, alcohol neuropathy resembles Wallerian degeneration. Ethanol and its toxic degradation metabolites affect neuronal metabolism including the metabolic pathways of nucleus, lysosomes, peroxisomes, endoplasmatic reticulum and cytoplasm [21].
What Are the Causes of This Type of Nerve Damage?
Thus, treatment with TCAs may provide symptomatic relief in patients with alcoholic neuropathy. Therefore, topical application with capsaicin may provide symptomatic relief from neuropathic pain in patients suffering from alcoholic neuropathy. Medicines may be needed to treat pain or uncomfortable sensations due to nerve damage. They will be prescribed the smallest dose of medicine needed to reduce symptoms.
- According to cancer treatment guidelines, radical surgery is the main cancer treatment, while chemotherapy and concurrent chemoradiotherapy are used as adjuvant treatments [1].
- Alcoholic neuropathy occurs when too much alcohol damages the peripheral nerves.
- Nine studies reported EMG findings in alcohol-related peripheral neuropathy patients.
- Especially if you have been drinking heavily for many years, coping with alcohol use disorder is not easy.
Treatment & Therapy
Further, serotonin-norepinephrine reuptake inhibitors are prescribed to treat alcohol-induced neuropathic pain via exerting antinociceptive properties by increasing serotonergic and noradrenergic neurotransmissions [71]. In an animal model, Kaur et al. (2017) showed that curcumin and sildenafil administrated alone or in combination represent a therapeutic advantage in alcohol-induced neuropathic pain [176]. Primarily, it was assumed that the progression of ALN symptoms is due to malnutrition and micronutrient deficiency (mainly B1 hypovitaminosis) [82, 83]. Indeed, these factors contribute to the progression of ALN symptoms; however, they do not constitute direct factors that manifest in ALN development [84]. Current postulation holds that dysfunctions within the central and peripheral nervous system are due to both direct and indirect toxic effects of alcohol [31, 85,86,87]. Indirect effects are mainly induced by vitamin deficiencies (B1, B2, B3, B5, B6, B7, B9, and B12) [84, 88].
- Indeed, these factors contribute to the progression of ALN symptoms; however, they do not constitute direct factors that manifest in ALN development [84].
- They work to send signals throughout the central nervous system and the rest of the body.
- Alcohol abuse affects the peripheral and the central nervous system adversely.
- According to a 2017 review, muscle myopathy is common in alcohol use disorder.
- It is likely to get worse if the person continues to use alcohol or if nutritional problems are not corrected.
In fact, a person who drinks heavily might not recognize that the symptoms they are experiencing are related to their alcohol consumption. Once alcohol use has been addressed, your doctor can focus on the neuropathy itself. Nerve damage can also make it difficult for you to carry out the functions of daily life. Identication of alcoholic neuropathy is based on history; there is no specific test that can specifically identify alcoholic neuropathy. Several treatment options and interventions can help a person recover from alcohol dependence.
The true incidence of alcoholic neuropathy in the general population is unknown, and figures vary widely depending on the definition of chronic alcoholism and the criteria used to detect and classify neuropathy. Accumulating evidence suggests a pivotal role for metabotropic glutamate receptors (mGluRs) in nociceptive processing, inflammatory pain and hyperalgesia [74, 75]. Several mGluR subtypes have been identified in the superficial dorsal horn of the spinal cord [76, 77] and on primary afferent fibres [78]. Glutamate concentrations are elevated in the superficial dorsal horn of rats after chronic ligature of the sciatic nerve [79]. Miyoshi et al. found that 5 weeks after ethanol treatment, the mechanical nociceptive threshold was significantly decreased and is further reduced up to 10 weeks [80]. As supported by immunostaining, the membrane fraction showed that spinal mGluR5 concentrations in ethanol-treated rats were significantly increased compared with those in the control diet group.
Safety of acupuncture-related interventions
A systematic review pointed out that acupuncture-E effectively decreased CIPN pain compared to Vitamin B [21]. One key advantage of electrical stimulation is the enhancement of analgesic action through a consistent and adjustable electric current and power [64]. Acupuncture-E effectively reduced CIPN symptoms in a study in which they improved motor and sensory disorders, especially by contributing to increased sensory nerve conduction velocity [20, 21]. As the nerve conduction velocity in the limbs increased, their functional status improved. This study also supports that the overall effect acupuncture-E and TEAS for managing CIPN symptoms and pain is superior to that of usual care, medication and vitamin B supplements. The primary axonal damage and secondary demyelination of motor and sensory fibres (especially small diameter fibres) are considered to constitute the morphologic basis of alcoholic damage to nerve tissue at present [20].
Peripheral neuropathy
Nerves help you to move (motor nerves) and feel physical sensations (sensory nerves). Some of your bodily functions are autonomic, which means that you don’t directly control them. Nerves that are part of the autonomic nervous system help to regulate heart rate, body temperature, respiration, and blood pressure. Polyneuropathy involves damage to more than one nerve at the same time, usually multiple nerves throughout the peripheral nervous system and all over the body. Of all the deleterious effects of excessive alcohol consumption, neuropathy is the most common.