Large and small fiber neuropathy in chronic alcohol‐dependent subjects

Abstract

The aim of the present study was to evaluate the occurrence of large and small fiber neuropathy among alcohol-dependent subjects and to correlate neuropathy with the pattern of alcohol abuse, age of the subjects, nutritional status, and biochemical parameters. The study sample comprised 98 consecutive alcohol-dependent subjects without signs of malnutrition treated for detoxification voluntarily in the specialized unit of the Athens University Psychiatric Clinic in an inpatient basis. Polyneuropathy (PN) was graded using the neuropathy symptoms score and neurologic disability score, conduction velocity studies, and quantitative sensory tests. Seventy-seven men and 21 women aged 27-70 years took part in the study. PN was diagnosed in 57 subjects (58.2%). PN of both large and small fibers was found in 25 patients (25.5%); exclusively small fiber neuropathy was observed in 12 (12.2%) and exclusively large fiber neuropathy in 20 patients (20.4%). Neuropathy was significantly correlated with the age of the subjects, duration of alcohol abuse, liver dysfunction, macrocytosis, and blood sugar levels upon admission. PN was significantly more frequent in males than in females. The two groups of exclusively large and exclusively small fiber neuropathy did not differ significantly in any clinical and laboratory parameter. Subclinical neuropathy (stage 1) was observed in 11.2%, which also did not differ significantly in any clinical and laboratory parameter from the stage 2 PN group subjects. Our findings indicate the direct toxic effect of alcohol on peripheral nerve fibers as the main etiologic factor of alcoholic PN. Long-standing hyperglycemia may be another contributing factor. Impaired vitamin B(12) utilization may be also involved.

Neuropathies in malnutrition and alcoholism

“…On electromyography distal denervation is seen. These studies are often abnormal in the presymptomatic patient [11]. In patients with chronic alcoholism combined with thiamine deficiency, CMAPs are more severely reduced [7].…”

“…The incidence of alcoholic polyneuropathy according to gender is controversial: according to Ammendola et al [4] it is higher in women than in men, Zambelis et al [11] found the reverse. The total lifetime amount of alcohol consumption and the duration of alcohol abuse are associated with ALN [3,11]. ALN is more prevalent in frequent, heavy, and continuous drinkers than in episodic drinkers [3].…”

“…The estimated prevalence of neuropathy in patients who suffer from alcoholism, as defined by DSM IV criteria, is between 25 and 66 % in the American population [4,11]. The incidence of alcoholic polyneuropathy according to gender is controversial: according to Ammendola et al [4] it is higher in women than in men, Zambelis et al [11] found the reverse. The total lifetime amount of alcohol consumption and the duration of alcohol abuse are associated with ALN [3,11].…”

Botulinum toxin type A combined with neurodynamic mobilization for lower limb spasticity: a case report

“…In the Western hemisphere, alcoholic peripheral neuropathy is most www.journalchiromed.com prevalent in the 40-to 70-year-old age group and is encountered in both men and women. 1,2 Long-term excessive alcohol consumption affects the peripheral and autonomic nervous systems. 1 Severe alcoholic polyneuropathy may cause difficulty walking, frequent falls, or paralysis.…”

“…1,2 Long-term excessive alcohol consumption affects the peripheral and autonomic nervous systems. 1 Severe alcoholic polyneuropathy may cause difficulty walking, frequent falls, or paralysis. 3 Spasticity is a state of hypertonicity with exaggeration of the tendon reflexes mediated by a loss of inhibitory control of the upper neurons.…”