NEUROLOGY,  NEUROPATHY

Alcoholic polyneuropathy 

  • progressive peripheral nerve injury due to a chronic alcohol use disorder 
  • Pathophysiology
    1. Likely multifactorial Mechanisms include  malnutrition (e.g., thiamine deficiency) and the toxic effects of Alcohol on the nervous system 
  • Clinical features:
    1. Symptoms usually begin in the distal lower extremities and progress slowly over months to years. 
    2. Sensory deficits: usually symmetrical
      • Numbness
      • Paresthesias
      • impaired vibration sense
      • Decreased proprioception
      • Burning feet syndrome
    3. Weakness of distal muscles
    4. Reduced or absent reflexes
    5. Rare: red, atrophic skin; muscle cramps
  • Diagnostics
    1. Usually diagnosed clinically, Laboratory studies help identify other conditions associated with alcohol use disorder
    2. Consider  electrodiagnostic studies if there is diagnostic uncertainty 
  • Treatment
    1. Cessation of  Alcohol use 
    2. Vitamin supplementation (e.g., thiamine) 

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