title: Alcohol-related peripheral neuropathy: nutritional, toxic, or both?
abstract: Alcohol-related peripheral neuropathy (ALN) is a potentially debilitating complication of alcoholism that results in sensory, motor, and autonomic dysfunction. Unfortunately, ALN is rarely discussed as a specific disease entity in textbooks because it is widely assumed to primarily reflect consequences of nutritional deficiency. This hypothesis is largely based on observations first made over eight decades ago when it was demonstrated that thiamine deficiency (beriberi) neuropathy was clinically similar to ALN. In recent studies, failure of thiamine treatment to reverse ALN, together with new information demonstrating clinical and electrophysiological distinctions between ALN and nutritional deficiency neuropathies, suggests that alcohol itself may significantly predispose and enhance development of neuropathy in the appropriate clinical setting. We reviewed the evidence on both sides and conclude that ALN should be regarded as a toxic rather than nutritional neuropathy.
authors.affiliation: Department of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Medical Office Center, 2 Dudley Street, Suite 555, Providence, Rhode Island 02905, USA. mmellion1@lifespan.org
authors.forename: Michelle
authors.initials: M
authors.lastname: Mellion
authors.forename: James M
authors.initials: JM
authors.lastname: Gilchrist
authors.forename: Suzanne
authors.initials: S
authors.lastname: de la Monte
mesh_terms: D020269:Alcoholic Neuropathy / Q000209:etiology / Q000378:metabolism*; D000437:Alcoholism / Q000150:complications / Q000378:metabolism*; D000818:Animals; D002986:Clinical Trials as Topic / Q000379:methods; D000431:Ethanol / Q000506:poisoning* / Q000633:toxicity; D006801:Humans; D009752:Nutritional Status / Q000187:drug effects / Q000502:physiology*; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000378:metabolism*; D013832:Thiamine Deficiency / Q000150:complications / Q000378:metabolism
chemical_list: D000431:Ethanol