Alcoholic neuropathy: possible mechanisms and future treatment possibilities
Open accessAbstract
Chronic alcohol consumption produces painful peripheral neuropathy for which there is no reliable successful therapy, mainly due to lack of understanding of its pathobiology. Alcoholic neuropathy involves coasting caused by damage to nerves that results from long term excessive drinking of alcohol and is characterized by spontaneous burning pain, hyperalgesia and allodynia. The mechanism behind alcoholic neuropathy is not well understood, but several explanations have been proposed. These include activation of spinal cord microglia after chronic alcohol consumption, oxidative stress leading to free radical damage to nerves, activation of mGlu5 receptors in the spinal cord and activation of the sympathoadrenal and hypothalamo‐pituitary‐adrenal (HPA) axis. Nutritional deficiency (especially thiamine deficiency) and/or the direct toxic effect of alcohol or both have also been implicated in alcohol‐induced neuropathic pain. Treatment is directed towards halting further damage to the peripheral nerves and restoring their normal functioning. This can be achieved by alcohol abstinence and a nutritionally balanced diet supplemented by all B vitamins. However, in the setting of ongoing alcohol use, vitamin supplementation alone has not been convincingly shown to be sufficient for improvement in most patients. The present review is focused around the multiple pathways involved in the development of peripheral neuropathy associated with chronic alcohol intake and the different therapeutic agents which may find a place in the therapeutic armamentarium for both prevention and management of alcoholic neuropathy.
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Alcoholic neuropathy is thought to be caused by the direct toxicity of alcohol to peripheral nerves due to long-term alcohol use and nutritional disorders such as vitamin deficiencies that often accompany alcohol use.
“Alcoholic neuropathy is thought to be caused by the direct toxicity of alcohol to peripheral nerves due to long-term alcohol use and nutritional disorders such as vitamin deficiencies that often accompany alcohol use.”
From The usefulness of deep tendon reflexes in the diagnosis of lumbar spine diseases: a narrative review (2024) · cites this paper as [39]
A report from the United States found that 25%-60% of alcohol-dependent persons had alcoholic neuropathy.
“A report from the United States found that 25%-60% of alcohol-dependent persons had alcoholic neuropathy [39]”
From The usefulness of deep tendon reflexes in the diagnosis of lumbar spine diseases: a narrative review (2024) · cites this paper as [39]
In alcoholic neuropathy, tendon reflexes are generally diminished and absent.
“Tendon reflexes were generally diminished and absent.”
From The usefulness of deep tendon reflexes in the diagnosis of lumbar spine diseases: a narrative review (2024) · cites this paper as [39]
Alcoholic neuropathy is a chronic, slowly progressive disease that typically takes the form of sensorimotor polyneuropathy with distal dominance in the lower extremities.
“which is a chronic, slowly progressive disease that typically takes the form of sensorimotor polyneuropathy with distal dominance in the lower extremities.”
From The usefulness of deep tendon reflexes in the diagnosis of lumbar spine diseases: a narrative review (2024) · cites this paper as [39]
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- Authors
- Chopra, K., & Tiwari, V.
- Affiliations
- Panjab University (IN)
- Corresponding author
- Chopra, Kanwaljit
- Venue
- British Journal of Clinical Pharmacology
- Publisher
- Wiley
- Published
- 2012-02-13
- Volume
- 73
- Issue
- 3
- Pages
- 348-362
- ISSN
- 0306-5251 (ISSN-L)
- 1365-2125
- PMC
- PMC3370340
- OpenAlex
- W1572142321
- Cited by
- 244
- References
- 133
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 25 · 2023: 26 · 2022: 23 · 2021: 17 · 2020: 20 · 2019: 23 · 2018: 15 · 2017: 13 · 2016: 9 · 2015: 9 · 2014: 17 · 2013: 14
- FWCI
- 1.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Clinical Pharmacology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- alcoholic neuropathy, chronic alcohol consumption, peripheral neuropathy, neuropathic pain, hyperalgesia, allodynia, oxidative stress, mGlu5 receptor, sympathoadrenal system, hypothalamic-pituitary-adrenal axis, thiamine deficiency, vitamin B12 supplementation, alcohol abstinence, neuropathic pain treatment
- MeSH terms
- Alcohol Drinking, Ethanol, Alcoholism, Humans, Hyperalgesia, Pain, Peripheral Nerves, Thiamine Deficiency, Time Factors, Pain Threshold, Alcoholic Neuropathy
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