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Alcoholic neuropathy is not well understood. For many years, it was attributed to the poor diet that alcoholics have, including the lack of vitamin B, particularly thiamine and folic acid. Some people have attributed it to toxic effects of alcohol. Personally, I am not sure that it is related to alcohol. Several attempts have been made to reproduce alcohol neuropathy by giving alcohol long-term to animals but without success. In my opinion, it is not a toxic effect of alcohol on the nerves but a nutritional deficiency. It is also possible that it is a result of toxins that may be present in certain types of alcohols. The diagnosis of alcohol neuropathy is demonstration of sensory deficits in the peripheral system (or slowed conduction time in the peripheral nerves) associated with prolonged heavy continuous alcohol consumption. It may manifest in other nerves besides the legs, particularly the vagus nerve which tends to show up as increased heart-rate (since the vagus nerve reduces heart rate) and other autonomic neuropathy. Alcoholic neuropathy occurs more frequently in women and involves multiple nerves, e.g. polyneuropathy. In general, the symptoms of alcoholic neuropathy include early numbness of the soles, particularly at night in the beginning. "Pins and needles" sensations develop and may progress to severe and lancinating pain. The symptoms start distally and progress proximally. When the symptoms involve areas above the ankle, some numbness of the fingertips may occur, with stocking and glove pattern of sensory involvement. Sensory ataxia may result. Autonomic dysfunction are more rare but may manifest as loss of heart rate reflex changes, abnormaly pupillary function, sexual impotence, and sleep apnea, orthostatic hypotension, hypothermia, and gait problems. If he does have alcohol neuropathy, the prognosis is good, if he stops drinking and has a normal diet The axons should regenerate. I don't know where the suggestion comes from that this is permanent but it is not true. If it does not reverse, this suggests that there is some other cause other than alcoholic neuropathy. Wise. |
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