Nervous System

Ethanol damages the CNS and peripheral nervous system by altering both neurotransmitter levels and cell membrane fluidity and function. Among the neu-

rological effects, alcoholic dementia and Wernicke-Korsakoff syndrome were discussed earlier. Hepatic encephalopathy occurs in the setting of severe liver failure as a result of either severe alcoholic hepatitis or cirrhosis. Early manifestations of encephalopathy include inappropriate behavior, agitation, depression, apathy, and sleep disturbance. Confusion, disorientation, and depressed mental status develop in the advanced stages of encephalopathy. Physical examination may demonstrate asterixis, tremor, rigidity, hyperreflexia, and fetor hepaticus. Treatment requires the elimination of the offending condition, dietary protein restriction, and removal of nitrogenous waste from the gut with osmotic laxatives and antibiotics (lactulose and neomycin, respectively) (Adams & Victor, 1989).

The most frequent neurological consequence of chronic alcohol intake is a toxic polyneuropathy, which results from inadequate nutrition, mainly deficiency of thiamine and other B vitamins. Additionally, there is a relationship to total lifetime dose of ethanol. Signs and symptoms are (1) distal sensory disturbances, with pain, paresthesia, and numbness in a glove-and-stockings pattern; (2) weakness and atrophy of distal muscles, pronounced in the lower limbs; (3) loss of tendon jerks; and (4) dysfunction of autonomic fibers. As a result, therapy consists of alcohol abstinence, high-calorie nutrition, parenteral thiamine, and other vitamins. For paresthesia and pain, carbamazepine, salicy-lates, and amitrytiline are effective. The prognosis of alcoholic polyneuropathy is favorable with alcohol abstinence. In chronic alcoholic patients, peripheral nerves frequently are injured by compression during alcohol intoxication. Peroneal nerve lesions result from compression in the region of the neck of the fibula during a prolonged lying position, and the radial nerve is injured during sitting with the upper arm placed on the backrest of a bench. Usually, pressure palsies resolve spontaneously (Schuchardt, 2000).

Peripheral Neuropathy Natural Treatment Options

Peripheral Neuropathy Natural Treatment Options

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