Alcoholic neuropathy: possible mechanisms and future treatment possibilities PMC
- Posted by Surya Abadi Dutaindo
- On 12 Februari 2021
It was observed that abstinence may lead to the regression of several symptoms of AAN [159]. Alcohol abuse causes a wide range of disorders that affect the nervous system. These include confusion, cerebellar ataxia, peripheral neuropathy, and cognitive impairment. Chronic and excessive alcohol consumption is the primary cause of peripheral neuropathy. It is worth noting that peripheral neuropathy has no reliable treatment due to the poor understanding of its pathology.
Alcohol-abusing patients with liver cirrhosis and vagus nerve neuropathy are at higher risk of a sudden death compared to patients without impairments within the nervous system [173, 174]. Four studies addressed the management of patients with alcohol-related peripheral neuropathy. These studies addressed abstinence from alcohol consumption and administration of vitamins.
Alcohol-Induced Causes Of Neuropathy
Only a small number of patients felt a weakness in the upper limbs. Eventually, it can cause a loss of nerve function, primarily https://ecosoberhouse.com/ in the extremities. Here is how alcoholic neuropathy can affect your life, including viable treatment options.
- Thirteen studies provided data from the biopsy of the sural nerve or the skin in patients with alcohol-related peripheral neuropathy.
- Protein kinase C (PKC) is a family of protein kinases consisting of approximately 10 isozymes.
- Due to similar histologic and electrophysiological symptoms, it was believed that ALN may make up a subtype of beriberi [146].
- Unfortunately, in most cases, the damage that alcoholic neuropathy causes is permanent.
- Antiepileptic drugs, such as the gamma aminobutyric acid (GABA) analogue (gabapentin), have proven helpful in some cases of neuropathic pain.
- The death receptor ligand, tumour necrosis factor α, and its downstream second messenger, ceramide, also produce pain-related behaviour via this mechanism.
Depletion of glutathione increases the susceptibility of neurones to oxidative stress and hyperalgesia [43, 44]. Fennelly and colleagues evaluated the response to vitamin therapy in 29 individuals alcohol neuropathy with alcohol-related neuropathy [30]. Patients were admitted and treated with a diet containing thiamine, nicotinic acid, pantothenic acid, pyridoxine, folic acid, and vitamin B12.
What Is Alcoholic Neuropathy, Exactly?
This type of degeneration, so called ‘dying-back’, resembles Wallerian degeneration. 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].
In 47 of these patients sural nerve biopsy was performed, with discrimination in terms of their thiamine status [3]. The ethanol consumption of these patients was more than 100 g day–1 for more than 10 years. These patients were divided into two groups based on thiamine status. The subgroup without thiamine deficiency consisted of 36 patients, while the subgroup with thiamine deficiency consisted of 28 patients.
Treatment for Alcoholic Neuropathy
N-acetylcysteine, an amino acid, is a potent antioxidant and helps to enhance glutathione concentrations. N-acetylcysteine may have application in the prevention or treatment of neuropathy. Rats with experimentally-induced diabetes for 2 months had a 20% reduction in nerve conduction velocity and 48% reduction in endoneurial blood flow. Both were largely corrected by N-acetylcysteine supplementation [111]. A mechanism of cisplatin chemotherapy-induced peripheral neuropathy was elucidated in an in vitro mouse model.
- When it comes to treating the condition, it is best to abstain from alcohol and restore your nutrient balance.
- Motor function of the tibial nerve was the next common [3, 11, 51, 54, 59, 63].
- This is also something that can have a long-term psychological impact.
- The primary aim of this systematic review was to establish the prevalence, character, and risk factors of peripheral neuropathy amongst chronic alcohol abusers and to identify the most appropriate management strategies.
- Deficiencies in B6 and B12, thiamine, folate, niacin, and vitamin E can make it worse.
- There are several tests that can be done to diagnose alcohol neuropathy and usually, more than one is necessary.
Beyond that, your physician will likely prescribe you a variety of different supplements, most likely thiamine and folic acid. These vitamins can help your body repair all the damage that it can. Your physician may also decide to prescribe pain relievers to help deal with alcoholic neuropathy’s effects. This, however, is dependent on your risk of abusing the pills as many opioids can be highly addictive. Females, generally tend to drink less alcohol, are better abstainers, and present the smaller probability of the development of alcohol-related diseases [127, 128].
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