Neuropathy is sometimes referred to as the 'silent disease', because not many people (including doctors and patients) know about it. Currently in the US alone 2,000,000 people are estimated to suffer from it, including about ten per cent of diabetics. Heavy alcohol users are also prone to peripheral neuropathies, a condition sometimes called alco-neuropathy1, which can have an insidious onset and there are many alcoholics out there with usually peripheral sensory, but also motor neuropathies. Likewise diabetics are also prone to peripheral neuropathies.
What is it?
Neuropathic means that your neural-system is damaged, and the condition comes in one or all of three forms, depending on which type of nerves have been damaged:
Sensory Neuropathic Damage - This is when some parts of your body lose all sensation. For example the loss of feeling in the hands or feet. Some parts of the body become hypersensitive and you wake up in the night screaming as you receive random pain signals from every nerve in your body. Sensory neuropathy is by far the most common manifestation of alcoholic neurological dysfunction. This is manifested by poor peripheral sensation and occasionally neuropathic pain - which is more common in diabetics and people with multiple sclerosis than in alcoholic peripheral neuropathy.
Autonomic Neuropathic Damage - This is when you can't feel when you need to go to the loo and you can't feel if you've already let it go. Alcoholics do not tend to get autonomic neuropathies, certainly not as commonly as say diabetics. Loss of bladder function is one manifestation of autonomic neuropathies but this is usually not being able to pass urine rather than being incontinent. Others are a fall in blood pressure on standing and a fast heart rate. A condition alcoholics can get is Wernicke-Korsakoff disease due to vitamin B1 deficiency and heavy alcohol abuse which leads to ataxia (poor co-ordination and unsteady walking) and dementia.
Motoric Neuropathic Damage - You're practically paralysed and can't do anything at all. Your mouth has problems with speaking, people have difficulty understanding what you're saying and muscles think they receive signals from your brain and start to move uncontrollably. Motor neuropathies do not tend to involve the muscles of the face but often involve muscles of the extremities, with decreased power making walking difficult and also decrease in proprioception2. Uncontrollable muscle movement is not characteristic of alcoholic neuropathy and occurs with primary brain lesions.
Not all sufferers of neuropathy have all three types of nerve damage. If only one type is damaged, the condition is called mononeuropathy; polyneuropathy usually means more than two nerve groups affected rather than a combination of sensory, autonomic and motor.
How Do You Get It?
B vitamins are essential, B1, B12, B6 and folate especially. However, in most cases the lack of vitamin B1 is not caused by eating too little. Vitamin B1 is broken down very quickly by alcohol, and drinking two bottles of wine or about eight bottles of beer a day for a few years will do the trick. The onset of peripheral neuropathy is often insidious, although stopping drinking does usually help.
Other common causes are related to diabetes, auto-immune disorders, or genetic problems. Sometimes it can be brought on by extreme trauma or shock.
Cures
If you're lucky you can be cured, but it will take at least six months and loads of medicine, a lot of hospital visits where they will push and pull at the most painful parts of your body, and a lot training for your weakened muscles. If you're less lucky, then it will take you years to recover, if you recover at all. There is a very small chance that you will regain about 90% of your nervous system. There is a big chance you will get back less.
1 Although this is not a term used in general medical parlance.
2 A term meaning being aware of the exact position of ones limbs.
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