Peripheral neuropathy refers to damage or disease of the nerves that carry messages to and from the brain or spinal column and the rest of the body. More recent research, however, suggests that alcohol can directly damage nerves. The evidence points toward alcohol-related peripheral neuropathy being a form of toxic neuropathy, rather than nutritional neuropathy.

International Patients

• Alcoholic neuropathy signs and symptoms can progress gradually and are usually subtle at first.
• As with any medical condition, prompt treatment is key to heal existing damage and prevent further harm.
• You may also be given an electromyogram (EMG) test and a nerve conduction velocity (NCV) test, which are used to check nerve and muscle function and measure the electrical properties of the nerves.
• Alcohol causes neuropathy via multifactorial processes, many of which are still under investigation.
• Light touch can feel exaggerated and painful, particularly in the fingers and toes.
• There are many studies suggesting the role of MEK/ERK signaling in inflammatory pain in male [60–63] and female rats [64].

Gabapentinoids, because of their nervous system-cooling effect, could also help address root causes that are driving patients to drink (and leading to worsening liver disease), Shah said. About a quarter of the veterans he studied had made a visit to the VA pain clinic, and more than 90% had mental health alcohol neuropathy stages visits. But there are some practical reasons why gabapentinoids might work better than other drugs for some patients, Shah said. For one thing, treatment with acamprosate requires patients to take six pills per day. The other FDA-approved medications, naltrexone and disulfiram, also have shortcomings.

Direct toxic effects of ethanol or its metabolites (direct toxicity)

• The most important strategy against alcoholic neuropathy lies in preventing the symptoms from getting worse by decreasing alcohol consumption as soon as possible.
• Tricyclic antidepressants (TCAs) are often the first line drugs to alleviate neuropathic pain symptoms.
• Over time, chronic alcoholism can deplete the body of essential nutrients, particularly B vitamins like thiamine, which are crucial for nerve health.
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A more comprehensive EMG analysis may be conducted when the patient has lumbosacral radiculopathy. The primary findings in alcohol-induced PN are a positive sharp wave, fibrillation potentials, and complex repetitive charges—electrical measures indicating severely degenerative muscle function. It is essential to provide patient education regarding the harmful, long-term consequences of alcohol abuse. Referral to a behavioral health addiction facility may be required to treat alcohol addiction. Treatment for alcoholism may include counseling, social support such as Alcoholics Anonymous (AA), or medicines.

Treatment for Alcoholic Neuropathy

• Thus, there is a need to screen acetyl-L-carnitine in both preclinical and clinical models of alcoholic neuropathy.
• Naltrexone (brand name ReVia, Vivitrol, and Depade) is hard on the liver, and can’t be used once patients reach severe levels of disease.
• This condition manifests when ethanol in alcohol and its metabolites, like acetaldehyde, harm nerve tissues, disrupting their normal functions.
• Symptoms include tingling or numbness in the extremities, muscle weakness, changes in gait, heightened sensitivity to touch, chronic pain, and in advanced cases, muscle atrophy and gastrointestinal disturbances.

As yet there is no effective therapeutic intervention available for relieving the neuropathic pain due to chronic alcohol consumption. An analysis of lab data may correlate with the patient’s neuropathic syndrome and systemic symptoms. Decreasing albumin, increasing bilirubin, and prolonged clotting factors may indicate hepatic decompensation.

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Selected systemic effects of heavy alcohol consumption

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