Alcohol-Induced Neuropathy in Chronic Alcoholism: Causes, Pathophysiology, Diagnosis, and Treatment Options
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THE PATHOBIOLOGY OF ALCOHOL CONSUMPTION (P MOLINA AND M RONIS, SECTION EDITORS)
Alcohol-Induced Neuropathy in Chronic Alcoholism: Causes, Pathophysiology, Diagnosis, and Treatment Options Iga Dudek 1 & Danuta Hajduga 1 & Cezary Sieńko 1 & Amr Maani 2 & Elżbieta Sitarz 3 & Monika Sitarz 4 & Alicja Forma 1 Accepted: 12 October 2020 # The Author(s) 2020
Abstract Purpose of the Review Alcohol abuse causes a wide range of disorders that affect the nervous system. These include confusion, cerebellar ataxia, peripheral neuropathy, and cognitive impairment. Chronic and excessive alcohol consumption is the primary cause of peripheral neuropathy. It is worth noting that peripheral neuropathy has no reliable treatment due to the poor understanding of its pathology. Recent Findings Coasting is a major feature of alcoholic neuropathy, largely due to chronic alcohol abuse. Its major features are hyperalgesia, allodynia, and burning pain. Even though much research was done in this area, still we do not have a full understanding of the mechanism of alcoholic neuropathy. However, some theories have been proposed. These include direct or indirect effects of alcohol metabolites, impaired axonal transport, suppressed excitatory nerve pathway activity, or imbalance in neurotransmitters. Activation of spinal cord microglia, mGlu5 spinal cord receptors, and hypothalamic-pituitary-adrenal axis also seem to be implicated in the pathophysiology of this alcoholic neuropathy. The goal of treatment is to impede further damage to the peripheral nerves while also restoring their normal physiology. Alcohol abstinence, intake of balanced diets, and treatment with medications are suggested including benfotiamine, alpha-lipoic acid, acetyl-L-carnitine, vitamin E, methylcobalamin, myo-inositol, N-acetylcysteine, capsaicin, tricyclic antidepressants, or antiepileptic drugs. Summary This review focuses on the many pathways that play a role in the onset and development of alcohol-induced neuropathy, as well as present the possible treatment strategies of this disorder, providing insights into a further search of new treatment modalities. Keywords Alcohol . Neuropathy . Peripheral nervous system . Autonomic nervous system . Ethanol . Alcohol metabolites
This article is part of the Topical Collection on The Pathobiology of Alcohol Consumption * Alicja Forma [email protected] Iga Dudek [email protected]
Elżbieta Sitarz [email protected] 1
Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland
2
Chair and Department of Human Anatomy, Medical University of Lublin, 20-090 Lublin, Poland
Cezary Sieńko [email protected]
3
Chair and 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439 Lublin, Poland
Amr Maani [email protected]
4
Department of Conservative Dentistry with Endodontics, Medical University of Lublin, 20-090 Lublin, Poland
Danuta Hajduga [email protected]
Curr Pathobiol Rep
Introduction Alcohol-related diseases are caused
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