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The term neuropathy may refer to several conditions that involve nerve damage and impaired nerve cell signaling within the nervous system.
Often, neuropathy refers to damage or impaired functioning in the peripheral nerves, which are nerves that transmit signals between the brain and spinal cord (i.e., the central nervous system, or CNS) and the periphery (i.e., the rest of the body). Peripheral nerves are responsible for a large number of voluntary and involuntary actions.
Three types of nerves can be involved in neuropathy:
In terms of the extent of any given neuropathy, a single nerve can be affected (a condition known as mononeuropathy) or multiple nerves can be affected (a condition known as polyneuropathy). In addition, combination neuropathies exist in which some combination of the above nerve pathways are affected (potentially all 3).
Several medical conditions are associated with the development of peripheral neuropathies—the signs, symptoms, and severity of presentation for which may vary.
Chronic drinking is a common cause of peripheral neuropathy. Alcoholic neuropathy can develop either as a result of the direct neurotoxic effects of alcohol and its metabolites (e.g., acetaldehyde) or in connection with certain drinking-related health issues, such as nutritional deficits and thiamine deficiency. Symptom presentation may vary somewhat for each type, though diminished sensation, paresthesia, burning pain, and sensitized or heightened pain response (primarily in the lower extremities) are common.
Other symptoms associated with alcoholic neuropathy include:
Some of the primary goals of treatment include:
The issue with treating neuropathy is that, in many cases, once the nerves are damaged, they may not return to their former level of functioning.
Neuropathic pain may be managed with medications such as gabapentin and amitriptyline as well as acetaminophen, aspirin or other NSAIDs. However, such measures merely address acute discomfort and do nothing to target the underlying pathology or halt disease progression. Though there may be no definitive means of reversing a peripheral neuropathy, the ultimate goal is to address the underlying cause of the neuropathy and prevent further damage while managing the current neuropathy-related issues.
Of course, the core approach to managing neuropathy in individuals who have alcohol abuse problems is to halt the underlying cause of neuropathy. Any person diagnosed with alcoholic neuropathy will be counseled to stop drinking—a process which may be facilitated (as well as made as safe and comfortable as possible) with a supervised medical detox period followed by longer-term alcohol rehabilitation.
All told, a comprehensive prescription for recovery might consist of: