Peripheral neuropathy Diagnosis and treatment

There are a number of ways in which neuropathy can be diagnosed, says Williams. Generally the process will start with your physician taking down a patient history that includes a description of your complaints, as well as a physical examination to check the functioning of the area in question. Nutrient deficiencies — whether caused by disease-related malabsorption, alcoholism, or an unbalanced diet — can also lead to neuropathy.

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Most patients presenting with clinical pattern #5 demonstrate reduced (often absent SNAPs) with normal motor CMAPs. Alcohol can have a toxic effect on nerve tissue, and alcohol abuse is one of the most frequent causes of neuropathy. According to studies, it is estimated that as many as 66% of individuals with chronic alcohol abuse may suffer from alcoholic polyneuropathy. Based on these studies, it can be determined that there is a high rate of peripheral neuropathy amongst chronic alcohol abusers. It also appears that the addition of NCS may improve the identification of alcohol-related peripheral neuropathy.

• Recently findings from our laboratory also suggest the benefecial effects of both α-tocopherol and tocotrienol, isoforms of vitamin E, in the prevention of hyperalgesia and allodynia in rats administered ethanol for 10 weeks [55].
• It also discusses treatment options, including how to get help for alcohol use disorder.
• Electrophysiologic and pathologic findings mainly indicate axonal neuropathy with reduced nerve fibre densities.

Alcoholic Neuropathy Symptoms

• The HNF is a great place for family members and caregivers to educate themselves.
• Nerve damage from chronic alcohol consumption can develop over several years.
• Endoneural oxidative stress leads to nerve dysfunction in rats with chronic constriction injury [39].
• Therefore, topical application with capsaicin may provide symptomatic relief from neuropathic pain in patients suffering from alcoholic neuropathy.
• For diabetic neuropathy, Matthew Villani, DPM, a podiatrist in Sanford, Florida, says he often recommends the multivitamin Metanx, which contains vitamin B12.

Because the symptoms of alcoholic neuropathy can be similar to those of other conditions, your doctor may first rule out other possible causes of your symptoms. The primary risk factor for alcoholic neuropathy is chronic consumption of large amounts of alcohol. In someone with alcohol use disorder who may consistently consume large amounts of alcohol, the chronic effect of alcohol on nerves can lead to permanent damage. It doesn’t happen overnight, but diabetes can cause nerve damage, especially if your blood sugar is out of control. Individuals with alcoholic neuropathy can make a partial or full recovery, depending on the extent and duration of their alcohol consumption.

Motor symptoms

You’ll also find newsletters, podcasts, and information on how to locate a local support group. Proper nutrition is key for preventing or treating any health issues that may be at the root of neuropathy. Williams says antidepressant and anti-seizure medications are “the types of categories we’re likely to turn to and can be most helpful.” This is because they act on pain from abnormal nerve firings or nerve signals. Quantitative Sensory Testing (QST) Used to assess damage to the nerve endings involved in sensing temperature and vibrations, QST uses computer testing to measure how the nerves in question react to these stimuli. You may then be referred to a doctor trained in nervous system disorders, also called a neurologist.

Some patients do not report pain but note a feeling of swelling and tightness in their feet. Autonomic fiber involvement may lead to additional symptoms, including dry mouth, dry eyes, constipation, bladder incontinence, orthostatic dizziness, sexual dysfunction, red or white skin discoloration, alcohol neuropathy or trouble sweating. Sometimes nerve damage can be addressed with surgery, says Peter Highlander, DPM, a podiatrist based in Bellevue, Ohio. Through neurolysis, any scar tissue or constricting tissue around or within a nerve may be removed in order to release pressure on the nerve.

Understanding and treating alcoholic neuropathy

One should, however, keep in mind that polyneuropathy may be multifactorial. Nevertheless, the combination of medical history, clinical examination, NCS, and laboratory tests, reveals the etiology of the polyneuropathy in up to 4 of 5 patients [7]. Depending on the individual clinical scenario, diagnostic workup shown in the flow chart may need modification, for instance, if specific test results are positive or patients present with a clinical pattern not shown in the flow chart.

Nerve biopsy

• Cause-specific treatment, pain control, and lifestyle modification are key elements in the team approach to managing small fiber neuropathy.
• Chronic Alcoholism Alcoholic neuropathy is considered one of the most common forms of neuropathy.
• Proper nutrition is key for preventing or treating any health issues that may be at the root of neuropathy.
• Based on the proposed clinical stratification, a biopsy might be only useful in patients with pattern#1 and #2, when atypical symptoms or additional tests suggest an acquired condition (i.e., vasculitis).
• It is likely to get worse if the person continues to use alcohol or if nutritional problems are not corrected.