What Is Alcohol-Related Neurologic Disease?
Alcohol-related neurologic diseases are a wide range of
conditions caused by alcohol intake. Alcohol is often consumed as a social beverage,
but it is considered a poisonous chemical. Drinking too much alcohol can have
devastating effects on the body. In particular, alcohol has a significant
negative effect on the nerves and muscle cells.
Aside from intoxication (drunkenness), drinking alcohol can
cause memory loss, seizures, headaches, blackouts, incoordination, dehydration,
and even death. Long-term abuse can damage the nervous system, liver, and other
organs. This damage may be irreversible. Drinking too much alcohol can also
alter levels of certain nutrients in your body. These include thiamine (vitamin
B1), folate (vitamin B9), and vitamins B6 and B12. These are needed for proper
nerve function. A poor diet can make problems even worse.
Alcohol-related neurologic disease includes the following
- Wernicke-Korsakoff syndrome (Wernicke’s encephalopathy
- alcoholic neuropathy
- alcoholic cerebellar degeneration
- alcoholic myopathy
- fetal alcohol syndrome
- alcohol withdrawal syndrome
- dementia and other cognitive deficits
Women are more susceptible to many of the negative consequences
of alcohol use, like nerve damage, when compared to men.
Moderate drinking is probably safe for most people. The best
way to prevent these diseases is to avoid alcohol.
What Causes Alcohol-Related Neurologic Disease?
Alcohol-related neurologic diseases are caused by excessive
consumption of alcohol. Two thirds of men and about one half of women in
America drink alcohol. Three quarters of those drinkers don’t encounter serious
negative effects from drinking alcohol (Burke, et al., 1999).
When alcohol is consumed, it is absorbed into the
bloodstream from the stomach and the small intestine. It is then broken down by
the liver and expelled from the body. The liver can only break down alcohol in
small amounts at a time. The alcohol will continue to circulate in the
bloodstream and eventually affect other organs.
Alcohol can have significant negative effects on the central nervous system (CNS). The CNS includes
the brain and spinal cord. Consumption also has negative effects on the peripheral nervous system (PNS). This includes
the nerves that send signals to the muscles and organs.
How alcohol affects the brain and nervous system depends on:
- how often a person drinks
- how much a person drinks
- the age at which a person starts to drink
- how long a person has been drinking
- genetic factors
- family history of alcoholism
- diet and general health
What are the Types of Alcohol-Related Neurologic Diseases and their Symptoms?
Alcohol abuse can have many direct and indirect effects on
the brain and nervous system. Examples of neurologic diseases caused by alcohol
Wernicke-Korsakoff disease (WKS)
This condition is caused by brain damage due to a deficiency
in thiamine (vitamin B1). Thiamine deficiency is common in alcoholics. There
are two different WKS syndromes:
encephalopathy is severe and short-lived. Symptoms include:
- mental confusion
- poor muscle coordination
- paralysis of the nerves that move the eyes
is long-lasting (chronic). It usually develops as
Wernicke's symptoms go away. Symptoms include:
- problems with learning and memory (amnesia)
- poor coordination
- difficulty walking (NIAAA)
This condition occurs when the peripheral nerves are damaged
by too much alcohol. This can be permanent. Deficiencies in B6 and B12, thiamine, folate, niacin, and vitamin E can make it worse.
These vitamins are all needed for proper nerve function. Symptoms include:
- numbness, tingling, and prickly sensations in
the arms and legs
- muscle spasms and cramps
- muscle weakness
- movement disorders
- urinary and bowel problems like incontinence, constipation,
- sexual dysfunction
- difficulty swallowing
- impaired speech
- vomiting and nausea
Alcohol withdrawal syndrome
Alcohol withdrawal syndrome occurs when someone who has been
drinking excessive amounts of alcohol for an extended period of time suddenly
stops drinking. Symptoms can develop just five hours after the last drink. They
can persist for weeks (NIH).
Common symptoms include:
- mood swings
- nausea and vomiting
A more serious version of withdrawal is called delirium tremens. This can cause confusion,
sudden mood changes, hallucinations, fever, hyperthermia, and seizures. These
symptoms occur on top of the symptoms of alcohol withdrawal (NIH).
Alcoholic cerebellar degeneration
This condition occurs when neurons in the cerebellum
deteriorate and die because of the damaging effects of alcohol. The cerebellum
is the part of the brain that controls coordination and balance. Symptoms
- unsteady walk
- tremor in the trunk of the body
- jerky movements of the arms or legs
- slurred speech
- rapid movements of the eyes (nystagmus) (NINDS)
Alcohol affects muscle fibers causing alcoholic myopathy. Drinking
too much alcohol over time can weaken the muscles. This condition can be acute
or chronic. Symptoms include:
- muscle weakness
- atrophy (decrease in muscle mass, also called
- muscle cramps
Fetal alcohol syndrome
Fetal alcohol syndrome occurs when a woman drinks alcohol
while she is pregnant. Risks for the baby include brain damage and developmental,
cognitive, and behavioral issues (NIH).
These issues can appear at any time during childhood. No amount of alcohol is
safe to drink while pregnant.
How Is Alcohol-Related Neurologic Disease Diagnosed?
Early diagnosis is important to prevent permanent
neurological damage. A thorough health history
and questionnaires related to alcohol intake may be used to help diagnose these
conditions. It is important that you fill out questionnaires about alcohol
intake and nutrition honestly. Diagnosis depends largely on noticing the signs
of alcohol abuse. These may include:
- neglecting major responsibilities at work,
school, or at home
- drinking while driving
- arrests for driving drunk or fighting while
- inability to limit drinking
- continued use of alcohol despite negative
Some tests can be performed by your doctor to rule out other
causes of neurologic symptoms.
How are Alcohol-Related Neurologic Disease Treated?
Avoiding alcohol is the best way to treat the conditions. The
earlier intake is stopped, the more likely you are to recover. Some people may
need inpatient rehab, especially people with alcoholism (alcohol dependence). Others
may just need social support from family and friends. Local Alcoholics
Anonymous (AA) support groups, national agencies, and helplines are also
available. The internet has opened up new ways of treating alcohol disorders.
Once alcohol intake is stopped, a doctor can address
specific symptoms. Every patient’s needs are different. Doctors should tailor
specific treatments and alcohol abstinence programs to the individual.
Treatment may include vitamins and supplements, physical
therapy, prescription medication, or painkillers. Intravenous (IV) thiamine may
reverse the symptoms of WKS. Delirium tremens is considered a medical
emergency. It requires a hospital stay. A patient may also need to be sedated
for more than a week until the alcohol withdrawal symptoms go away (NIH). A
doctor can use brain-imaging techniques to monitor treatment over time.
How Can Alcohol-Related Neurologic Disease be Prevented?
Early intervention by physicians or family and friends can
help people avoid these problems.
You should educate yourself on how much alcohol is
considered too much. Moderate alcohol intake is defined as up to one drink per
day for women and up to two drinks per day for men. The best way to prevent
alcohol-related neurologic disease is to not drink any alcohol at all.
What Can Be Expected Long-Term?
Your condition can get worse if you continue to drink
alcohol. Permanent damage to the nervous system and other parts of the body might
occur. This may lead to disability, chronic pain, and even death. Completely
avoiding alcohol and eating a healthy diet can minimize damage.
A full recovery is possible. This depends on how early the disease
is diagnosed and how much damage has already occurred. It also depends on how
motivated a patient is to recover. Most alcoholics with mental damage show
some improvement in brain functioning within a year of giving up alcohol. Some
people take much longer (NIAAA).