eMedicine Specialties > Neurology > Neurotoxicology

Alcohol (Ethanol) Related Neuropathy: Treatment & Medication

Author: Tarakad S Ramachandran, MBBS, FRCP(C), FACP, Professor of Neurology, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Chair, Department of Neurology, Crouse Irving Memorial Hospital
Coauthor(s): Charles Gellido, MD, Laboratory Director, Assistant Professor, Department of Neurology, Jacobi Medical Center, Albert Einstein College of Medicine
Contributor Information and Disclosures

Updated: Jun 15, 2009

Treatment

Medical Care

Treatment is directed toward stopping further damage to the peripheral nerves and returning to normal functioning. These can be achieved by alcohol abstinence, a nutritionally balanced diet supplemented by all B vitamins, and rehabilitation. However, in the setting of ongoing ethanol use, vitamin supplementation alone has not been convincingly shown to be sufficient for improvement in most patients.

According to Dina et al, adrenal medullectomy and administration of glucocorticoid receptor antagonist mifepristone (RU 38486) prevented and reversed a model of painful peripheral neuropathy in alcohol binge-drinking rats. Their results suggest a convergence of the effects of mediators of the hypothalamic-pituitary-adrenal axis and the sympathoadrenal-stress axis on sensory neurons in the induction and maintenance of alcohol-induced painful peripheral neuropathy .14

More on Alcohol (Ethanol) Related Neuropathy

Overview: Alcohol (Ethanol) Related Neuropathy
Differential Diagnoses & Workup: Alcohol (Ethanol) Related Neuropathy
Treatment & Medication: Alcohol (Ethanol) Related Neuropathy
Follow-up: Alcohol (Ethanol) Related Neuropathy
References

References

  1. Lettsom JC. Some remarks on the effects of lignum quassiae amarae. Mem Med Soc Lond. 1787;1:128.

  2. Jackson J. On a peculiar disease resulting from the use of ardent spirits. N Engl J Med Surg. 1822;11:351.

  3. Shattuck GC. The relation of beri-beri to polyneuritis from other causes. Am J Tropical Med. 1928;83539-43.

  4. Behse F, Buchthal F. Alcohol Neuropathy: Clinical, Electrophysiological and Biopsy Findings. Ann Neurol. 1977;2:95-110.

  5. Monforte R, Estruch R, Valls-Sole J, et al. Autonomic and peripheral neuropathies in patients with chronic alcoholism. A dose-related toxic effect of alcohol. Arch Neurol. Jan 1995;52(1):45-51. [Medline].

  6. Hallett M, Fox JG, Rogers AE, et al. Controlled studies on the effects of alcohol ingestion on peripheral nerves of macaque monkeys. J Neurol Sci. Aug 1987;80(1):65-71. [Medline].

  7. Dina OA, Khasar SG, Alessandri-Haber N, Bogen O, Chen X, Green PG. Neurotoxic catecholamine metabolite in nociceptors contributes to painful peripheral neuropathy. Eur J Neurosci. Sep 2008;28(6):1180-90. [Medline].

  8. Koike H, Mori K, Misu K, Hattori N, Ito H, Hirayama M. Painful alcoholic polyneuropathy with predominant small-fiber loss and normal thiamine status. Neurology. Jun 26 2001;56(12):1727-32. [Medline].

  9. Koike H, Sobue G. Alcoholic neuropathy. Curr Opin Neurol. Oct 2006;19(5):481-6. [Medline].

  10. Johnson RH, Robinson BJ. Mortality in alcoholics with autonomic neuropathy. J Neurol Neurosurg Psychiatry. Apr 1988;51(4):476-80. [Medline].

  11. Avaria Mde L, Mills JL, Kleinsteuber K, et al. Peripheral nerve conduction abnormalities in children exposed to alcohol in utero. J Pediatr. Mar 2004;144(3):338-43. [Medline].

  12. Kharbanda PS, Prabhakar S, Chawla YK, Das CP, Syal P. Peripheral neuropathy in liver cirrhosis. J Gastroenterol Hepatol. Aug 2003;18(8):922-6. [Medline].

  13. Agelink MW, Malessa R, Weisser U, et al. Alcoholism, peripheral neuropathy (PNP) and cardiovascular autonomic neuropathy (CAN). J Neurol Sci. Dec 11 1998;161(2):135-42. [Medline].

  14. Dina OA, Khasar SG, Alessandri-Haber N, Green PG, Messing RO, Levine JD. Alcohol-induced stress in painful alcoholic neuropathy. Eur J Neurosci. Jan 2008;27(1):83-92. [Medline].

  15. Hillbom M, Wennberg A. Prognosis of alcoholic peripheral neuropathy. J Neurol Neurosurg Psychiatry. Jul 1984;47(7):699-703. [Medline].

  16. Adams R, Victor M. Diseases of the nervous system due to nutritional deficiency. In: Principles of Neurology. McGraw-Hill; 1977:757.

  17. Brust JCM, Britton C, Chiriboga CA, et al. Mancall EL, ed. Neurological Complications of Substance Abuse. Vol 3. 1997:89.

  18. Novak DJ, Victor M. The vagus and sympathetic nerves in alcoholic polyneuropathy. Arch Neurol. Apr 1974;30(4):273-84. [Medline].

  19. Victor M. Polyneuropathy due to nutritional deficiency and alcoholism. In: Dyck P, Thomas P, Lambert E, Bunge R, eds. Peripheral Neuropathy. Philadelphia: 1984:1899.

  20. Windebank AJ. Polyneuropathy due to nutritional deficiency and alcoholism. In: Dyck P, Thomas P, Lambert E, Bunge R, eds. Peripheral Neuropathy. Philadelphia: 1993:1310.

Further Reading

Keywords

alcoholic neuritis, neuritic beriberi, neuropathic beriberi, alcohol-related neuropathy, ethanol neuropathy, alcohol neuropathy, alcoholic peripheral neuropathy, ethanol-related neuropathy, peripheral nerve disease

Contributor Information and Disclosures

Author

Tarakad S Ramachandran, MBBS, FRCP(C), FACP, Professor of Neurology, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Chair, Department of Neurology, Crouse Irving Memorial Hospital
Tarakad S Ramachandran, MBBS, FRCP(C), FACP is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American College of Forensic Examiners, American College of International Physicians, American College of Managed Care Medicine, American College of Physicians, American Heart Association, American Stroke Association, Royal College of Physicians, Royal College of Physicians and Surgeons of Canada, Royal College of Surgeons of England, and Royal Society of Medicine
Disclosure: Abbott Labs  Honoraria Consulting; Teva Marion Honoraria Consulting; Boeringer-Ingelheim Honoraria Speaking and teaching

Coauthor(s)

Charles Gellido, MD, Laboratory Director, Assistant Professor, Department of Neurology, Jacobi Medical Center, Albert Einstein College of Medicine
Charles Gellido, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

Medical Editor

Jonathan S Rutchik, MD, MPH, Assistant Professor, Department of Occupational and Environmental Medicine, University of California at San Francisco
Jonathan S Rutchik, MD, MPH is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Occupational and Environmental Medicine, and Society of Toxicology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Neil A Busis, MD, Chief, Division of Neurology, Department of Medicine, Head, Clinical Neurophysiology Laboratory, University of Pittsburgh Medical Center-Shadyside
Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Stephen A Berman, MD, PhD, Professor, Department of Internal Medicine, Section of Neurology, Dartmouth Medical School; Chief, Neurology Service, White River Junction Veterans Medical Center
Stephen A Berman, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

 
 
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