Alcohol-Related Neurologic Disease

Written by Jacquelyn Cafasso
Medically Reviewed by George Krucik, MD, MBA on May 30, 2013

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 conditions:

  • Wernicke-Korsakoff syndrome (Wernicke’s encephalopathy and Korsakoff psychosis)
  • 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.

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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
  • gender
  • 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 include:

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:

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

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

Korsakoff’s psychosis is long-lasting (chronic). It usually develops as Wernicke's symptoms go away. Symptoms include:

  • problems with learning and memory (amnesia)
  • forgetfulness
  • poor coordination
  • difficulty walking (NIAAA)

Alcoholic neuropathy

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, 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. They can persist for weeks (NIH). 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, 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 include:

  • 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)

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 (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 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 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).

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