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Alcohol-Related Neurologic Disease

What is alcohol-related neurologic disease?

Alcohol-related neurologic disease is a range of conditions caused by alcohol intake. Alcohol is often consumed as a social beverage, but it’s considered a poisonous chemical. Drinking too much alcohol can have devastating effects on the body. In particular, alcohol has a significant negative effect on nerves and muscle cells.

Aside from intoxication, or drunkenness, drinking alcohol can cause other conditions, including:

  • memory loss
  • seizures
  • headaches
  • blackouts
  • incoordination
  • dehydration
  • 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, including:

  • thiamine, or vitamin B-1
  • folate, or vitamin B-9
  • vitamins B-6 and B-12

These vitamins are needed for proper nerve function. A poor diet can make problems even worse.

Alcohol-related neurologic disease includes the following conditions:

Women are more susceptible than men to many of the negative consequences of alcohol use, such as nerve damage.

Moderate drinking is probably safe for most people. But the best way to prevent alcohol-related neurologic disease is to avoid it.

What are the types of alcohol-related neurologic disease and their symptoms?

Symptoms

Alcohol abuse can have many direct and indirect effects on the brain and nervous system. Examples of neurologic disease caused by alcohol, along with their symptoms, include:

Wernicke-Korsakoff disease (WKS)

This condition is caused by brain damage due to a thiamine, or vitamin B1, deficiency. Thiamine deficiency is common in people who misuse alcohol. There are two different WKS syndromes:

Wernicke’s encephalopathy is severe and short-lived. Symptoms include:

  • mental confusion
  • poor muscle coordination
  • paralysis of the nerves that move the eyes

Korsakoff psychosis is long-lasting, or chronic. It usually develops as Wernicke's symptoms go away. Symptoms may include:

  • problems with learning and memory, including amnesia
  • forgetfulness
  • poor coordination
  • difficulty walking

Alcoholic neuropathy

This condition occurs when the peripheral nerves are damaged by too much alcohol. This can be permanent. Deficiencies in B-6 and B-12, 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, and diarrhea
  • sexual dysfunction
  • difficulty swallowing
  • impaired speech
  • dizziness
  • 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 and can persist for weeks. Common symptoms include:

  • anxiety
  • depression
  • fatigue
  • mood swings
  • shakiness
  • nightmares
  • headache
  • sweating
  • nausea and vomiting
  • insomnia

A more serious version of withdrawal is called delirium tremens. This can cause:

  • confusion
  • sudden mood changes
  • hallucinations
  • fever
  • hyperthermia
  • seizures

These symptoms can occur in addition to the symptoms of alcohol withdrawal.

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 may include:

  • unsteady walk
  • tremor in the trunk of the body
  • jerky movements of the arms or legs
  • slurred speech
  • rapid movements of the eyes, called nystagmus

Alcoholic myopathy

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 wasting)
  • muscle cramps
  • stiffness
  • spasms

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. These issues can appear at any time during childhood. No amount of alcohol is safe to drink while pregnant.

What causes alcohol-related neurologic disease?

Causes

Alcohol-related neurologic disease is caused by excessive consumption of alcohol. When you consume alcohol, it is absorbed into your 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
  • gender
  • genetic factors
  • family history of alcoholism
  • diet and general health

How is alcohol-related neurologic disease diagnosed?

Diagnosis

Early diagnosis is important to prevent permanent neurological damage. Your doctor will take a thorough health history and have you complete questionnaires related to alcohol intake 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 drunk
  • inability to limit drinking
  • continued use of alcohol despite negative consequences

Some tests can be performed by your doctor to rule out other causes of neurologic symptoms.

How is alcohol-related neurologic disease treated?

Treatment

Avoiding alcohol is the best way to avoid these conditions and relieve symptoms. The earlier you stop intake, the more likely you are to recover. You may need inpatient rehab, especially if you exhibit alcoholism or alcohol dependence. A good source of help is support from family and friends. Other support sources include:

  • local Alcoholics Anonymous (AA) support groups
  • national agencies
  • helplines

Once you stop alcohol intake, a doctor can address your specific symptoms. Every person’s needs are different. Doctors tailor specific treatments and alcohol abstinence programs to the individual.

Treatment may include:

  • vitamins and supplements
  • physical therapy
  • prescription medication
  • painkillers

Intravenous thiamine may reverse the symptoms of WKS. But delirium tremens is a medical emergency and requires a hospital stay. You may need to be sedated for more than a week until the alcohol withdrawal symptoms go away. And a doctor may use brain-imaging techniques to monitor treatment over time.

What can you expect long-term?

Next steps

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
  • death

Completely avoiding alcohol and eating a healthy diet can minimize damage. And a full recovery is possible. Your chances depend on how early the disease is diagnosed and how much damage has already occurred.

It also depends on how motivated you are to recover. According to the National Institute on Alcohol Abuse and Alcoholism, most people who misuse alcohol and have mental damage show some improvement in brain functioning within a year of giving up alcohol. For others, improvement may take longer.

How can alcohol-related neurologic disease be prevented?

Prevention

Early intervention by doctors or family and friends can help you avoid alcohol-related neurologic disease.

Steps you can take for prevention include:

  • educating yourself on how much alcohol is considered too much
  • limiting your daily alcohol intake to one drink or less for women, and two drinks or less for men

Ultimately, the best way to prevent alcohol-related neurologic disease is to not drink any alcohol at all.

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