Alcoholic neuropathy
Alternative names:
neuropathy - alcoholic; alcoholic polyneuropathy
Treatment:
Treatment goals (assuming the immediate alcohol problem
has been addressed) include controlling symptoms, maximizing
ability to function independently, and preventing injury.
The following may occur in treatment.
Physical therapy and/or use of orthopedic appliances such
as splints may be necessary
to maximize muscle function
and to maintain useful positioning of the limbs.
Medication may be used if necessary to treat pain or uncomfortable
sensations. Response to medications varies. The least amount
of medication needed to reduce symptoms is advised, to reduce
dependence and other side effects of the chronic
use.
Common medications used may include over-the-counter analgesics
such as aspirin (see
salicylates - oral),
ibuprofen, or acetaminophen
- oral to reduce pain. Stabbing pains may respond to tricyclic
antidepressants or anticonvulsant medications such as
phenytoin or carbamazepine.
A nutritious diet should be encouraged. Nutritional supplements
may be recommended.
Positioning, or the use of a bed frame that keeps the covers
off the legs, may reduce pain for some people.
Treatment of autonomic dysfunction (such as blood
pressure problems, difficulty with urination, and slow
gastrointestinal movement) may be necessary. Treatment may
be chronic, long-term, and response to treatment is varies.
Many treatments may be tried before finding one that is successful
in reducing symptoms. Use of elastic stockings, sleeping with
the head elevated, or medications such as fludrocortisone
may reduce postural blood pressure changes (orthostatic hypotension).
Manual expression of urine, intermittent catheterization,
or medications such as bethanechol may be necessary to treat
bladder dysfunction.
Impotence, diarrhea,
constipation, or other
symptoms are treated as appropriate. These symptoms may respond
poorly to treatment.
It is important to protect an extremity with reduced sensation
from being injured. This may include checking the temperature
of bath water to prevent burns,
change in footwear, frequent inspection
of shoes to reduce injury caused by pressure or objects in
the shoes, or other measures. Extremities should be guarded
to prevent injury from pressure.
Use of alcohol should be stopped to reduce progression of
the damage. Treatment of alcoholism
may include psychiatric interventions, social support such
as AA (Alcoholics Anonymous), medications, and behavior modification.
Expectations (prognosis):
Damage to nerves from alcoholic neuropathy is usually permanent
and may be progressive if use of alcohol is not stopped. Symptoms
vary from mild discomfort to severe disability. The disorder
is usually not life threatening, but may severely compromise
the quality of life.
Complications:
- disability
- discomfort or pain, chronic
- injury to extremities
Calling your health care provider:
Call for an appointment with your health care provider if
symptoms indicate alcoholic neuropathy may be present.
Update Date: 02/09/00
Updated by: J. Gordon Lambert, MD, Associate Medical Director,
Utah Health Informatics and adam.com
editorial
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