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Alcoholic neuropathy: causes, effects and treatment

Alcoholic neuropathy: causes, effects and treatment

July 14, 2024

Neuropathies, or clinical disorders of the nervous system, are a large group of heterogeneous diseases that affect the nerves responsible for making the body work . While some affect the peripheral nervous system, resulting in alterations in motility and sensitivity, others attack the autonomic nervous system.

Alcoholic neuropathy, a nervous system disorder caused by alcohol consumption , is of peripheral affectation. Let's see in what ways the nervous damage of alcoholic origin is manifested.

  • Related article: "The 8 signs of alcohol addiction"

Clinic in alcoholic neuropathy

People dependent on alcohol suffer marked effects on their nervous system. Almost 10% of alcoholics who consume high doses of ethanol Chronically they end up suffering from alcoholic neuropathy in some of its forms.

These patients with alcoholic neuropathy they suffer damage to axons of neurons motor and those responsible for sensitivity. Bilateral paresthesias occur in both arms and legs, numbness, tingling sensation and paresthesias, which are accentuated more in the hands and feet. In addition, disorders of gait and posture may occur due to degeneration or atrophy of the cerebellum, as well as nystagmus, a brief and involuntary movement of the eyes.

Fortunately, the involvement of the autonomic nervous system, which maintains vital functions such as respiration, cardiac contractions, etc. it is mild in this disease . The most relevant autonomous symptom is the inability to have an erection and maintain it, that is, impotence. However, there are autonomous symptoms when alcoholic neuropathy is accompanied by a syndrome characteristic of alcohol dependents: Wernicke's disease.

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Wernicke encephalopathy

Wernicke's encephalopathy, which is not exclusive but particular to alcoholics, consists of inability to move the eyes, difficulty in coordinating movements organized and a confusional state where the patient is absolutely disoriented. When someone suffers from this disease together with alcoholic neuropathy, we speak of polyneuropathies, since both syndromes coexist.

It is a medical emergency which requires the immediate administration of thiamin (vitamin B1). As this symptom is resolved, the patient begins to show an amnesiac picture. It's Korsakoff's psychosis.

Korsakoff syndrome

The second phase of this syndrome is called Korsakoff's psychosis. It is characterized by inability to remember past events in time (temporary gaps), conspiracy and antegrade amnesia.

Because this pair of syndromes almost always occur together, there is talk of a single Wernicke-Korsakoff syndrome, a two-phase disease where the most severe neurological symptoms of the first, when resolved, give way to the amnestic phase of the second.

  • Related article: "Wernicke-Korsakoff syndrome: causes and symptoms"

Causes of alcoholic neuropathy

The majority of neurological diseases associated with alcohol consumption they have to do with a vitamin deficit . Alcoholic beverages, besides inhibiting hunger through their psychoactive characteristics, contain many calories.

The brain, upon receiving the signal that this hypercaloric intake has occurred, interprets that it should not eat more and inhibits the hunger signal. A) Yes, the alcoholic feels satiated despite not having eaten anything nutritious .

Specifically, as in the Wernicke-Korsakoff, thiamine plays a crucial role in the development and resolution of the clinical picture.

1. Thiamin deficiency

It is common to find a nutritional deficit of this vitamin in patients who have abused alcohol chronically, patients who vomit very frequently or patients undergoing bariatric surgery.

Alcoholic neuropathy caused by thiamine deficiency begins after depriving the body of this vitamin for a long time. It starts with a mild loss of sensation, subtle sensations of burning in the toes and cramping in the legs. Later on, the sensitivity of the extremities will begin to be lost.

Whether it is a pure alcoholic neuropathy or accompanied by Wernicke-Korsakoff, this deficit will be resolved with the intramuscular or intravenous administration of vitamin B1 .

2. Deficiency of piroxidine

Although more infrequent, it is possible that the neuropathy is partially caused by the absence of vitamin B6. Both its excess and its absence can cause neurological damage , but in the abuse of alcohol only its deficit is found. Like thiamin, it can be detected through an analytic.

3. Pellagra

Pellagra is the deficiency of niacin (vitamin B3) due to malnutrition or alcoholism. The neurological manifestations are variable: they affect the central nervous system and also the peripheral nerves.


Alcoholic neuropathy is a severe neurological disease that must be treated immediately. Fortunately, its urgent handling usually leads to a partial recovery , without serious long-term consequences. Depending on the severity of the condition, the person who has suffered the disease will take more or less time to recover.

Nowadays it is possible to make an accurate diagnosis of alcoholic neuropathy through the analytical to detect vitamin deficits and the electrodiagnostic nerve conduction tests and electromyograms . In this way the treatment can be administered quickly and effectively for a complete recovery.


Medical intervention in cases of alcoholic neuropathy always involves the withdrawal of consumption of the substance that produced it. In addition, vitamin B supplements, especially B12 and thiamine, are used to promote recovery. As a support, it is important to make sure that the diet of the patients is sufficiently nutritious .

Peripheral Neuropathy (July 2024).

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