Alcoholic Neuropathy: Symptoms, Causes, and Treatment

Protein kinase C (PKC) is a family of protein kinases consisting of approximately 10 isozymes. PKC is involved in receptor desensitization, modulating membrane structure events, regulating transcription, mediating immune responses, regulating cell growth and in learning and memory. These functions are achieved by PKC mediated phosphorylation of other proteins [16]. Apart from above function, over-activation of epsilon form of protein kinase C (PKCε) is known to be involved in mediating neuropathic pain, such as pain induced by cancer chemotherapy (vincristine) [56] and diabetes [57].

Clinical management of alcoholic neuropathy

People who drink too much may start to feel pain and tingling in their limbs. Alcoholic neuropathy is a severe condition that can lead to chronic pain, loss of some bodily functions, and permanent disability. However, recognizing the symptoms and seeking medical attention early can minimize the impact of the condition. The best thing a person with alcoholic neuropathy can do is to stop or significantly reduce their alcohol intake. The medical community has recognized that addiction is a disease and some people are predisposed to it.

Nursing care

In general, the nerves in lower limbs were more affected than the upper limbs [3, 37–39]. Four studies reported abnormalities only in sensory nerves [33, 47, 63, 64], while ten reported abnormalities in both sensory and motor nerves [2–4, 16, 38, 54, 56, 58, 59, 65]. This may be a reflection of the severity of the neuropathy in which motor nerve function is affected at a later stage. 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 did [4, 67].

• Neuropathy has multifactorial causes, ranging from nutritional deficiencies to the toxic effects that alcohol has on neurons.
• Nerve damage can also make it difficult for you to carry out the functions of daily life.
• Even though alcoholic neuropathy may not go away, there are things you can do to cope with this condition.
• Primarily, thiamine deficiency is the crucial risk factor of ALN since it induces the progression of Korsakoff’s syndrome and beriberi [144, 145].
• The authors noted that Danish beer at the time of the study contained thiamine and vitamin B6.

Alcoholic neuropathy: possible mechanisms and future treatment possibilities

Patients present with pain, ataxia and parasthesias in the lower extremities. This activity describes the evaluation and management of alcoholic neuropathy and reviews the role of the interprofessional team in improving care for patients with this condition. Alcoholic neuropathy, also known as alcoholic peripheral neuropathy, refers to damage of the nerves due to chronic and excessive alcohol consumption. Affected nerves include the peripheral nerves, primarily located in the arms and legs, and the autonomic nerves, which help regulate our internal body functions. Chronic alcohol consumption leads to malnutrition with dysfunctions in protein and lipid metabolism which affect the metabolic pathways and progression of ALN symptoms within the central and peripheral nervous systems [89].

Decreased Sensation

Ethanol and its toxic degradation metabolites affect neuronal metabolism including the metabolic pathways of nucleus, lysosomes, peroxisomes, endoplasmatic reticulum and cytoplasm [21]. Alcohol enters the blood as early as 5 min after ingestion and its absorption peaks after 30–90 min. The key role in the degradation of ethanol is played by ethanol dehydrogenase and acetaldehyde dehydrogenase-two step enzymatic systems by which ethanol is converted to acetate which is further metabolized in humans. 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].

What is alcoholic neuropathy?

But if you have developed neuropathy as a result of alcohol use, it’s important to stop drinking as soon as possible. Professional and peer help through programs such as Alcoholics Anonymous or other substance abuse programs can help you reduce your alcohol consumption. Talk to your healthcare provider about the best treatment plan to start on your road to recovery. However, it is known to be directly related to heavy and long-term alcohol consumption.

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• Seek medical care right away if you notice unusual tingling, weakness, or pain in your hands or feet.
• The control group received routine treatment and care, whereas the intervention group received gradient pressure therapy based on routine treatment and care.
• Progression of symptoms is usually gradual, continuing over months or years [2, 4].

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]. Motor function of the tibial nerve was the next common [3, 11, 51, 54, 59, 63]. Finally, one study examined the strength-duration alcohol neuropathy stages time constant (SDTC) and rheobase in median nerves of those with alcoholic peripheral neuropathy [69]. The SDTC was normal compared to controls, but the rheobase was significantly different suggesting that APN may affect internodal channels other than nodal channels or the Na+ –K+ ATP pump. The nerves that run outside of the spinal cord and brain are called peripheral nerves.

Regeneration of peripheral nerves takes time and requires the patient and interprofessional team to collaborate to improve the patient’s symptoms. Abstinence from alcohol as a part of the treatment plan will help provide the best outcome to enhance the patient’s quality of life. Benfotiamine, a synthetic derivative of vitamin B1, improves neuropathic pain and motor movement by increasing nerve conduction velocity.

Symptoms & Signs

Nerve degeneration progresses from sensory symptoms to include motor function problems of the lower and upper extremities. Patients may stand and walk with a wide base of support to maintain balance. They may have peroneal nerve damage, causing foot drop with difficulty raising the feet sufficiently to walk safely without stumbling. Patients may have difficulty buttoning a shirt or blouse and with handwriting and holding objects. Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.