Alcoholic polyneuropathy of the hands and lower extremities: symptoms and treatment. Alcoholic neuropathy

Polyneuropathy is one of the most common complications of alcoholic disease. Currently, there are 3 main forms of alcoholic polyneuropathy: acute, subacute and chronic. They have a different clinical picture and mechanisms of development. Neurologists at the Yusupov Hospital use modern methods to study patients suffering from alcoholic polyneuropathy. Complex therapy is carried out with effective drugs that have minimal side effects.

During treatment, patients stay in the comfortable wards of the neurology clinic. They are provided with individual personal hygiene products and diet food. The clinic staff guarantees the anonymity of treatment. The tactics of treating patients with a severe course of the disease are discussed by candidates and doctors of medical sciences, doctors of the highest category at a meeting of the expert council. Leading experts in the field of neurology of the peripheral nervous system collectively develop tactics for treating the patient.

With chronic alcohol intoxication, degeneration of the processes of nerve cells - axons - occurs. It is accompanied by secondary myelinopathy in the form of segmental demyelination (loss of myelin) and remyelination (restoration of the myelin sheath of the nerve). Chronic toxic polyneuropathy develops more often. It is caused by the direct toxic effects of ethanol and its metabolic products, which affect both myelinated and non-myelinated thin nerve fibers. The latter conduct temperature and pain sensitivity, provide vegetative-trophic functions.

The toxic effect of alcohol on autonomic and somatic nerve fibers. depends on the amount of alcohol consumed. The average daily dose of alcohol over 100 g significantly increases the likelihood of developing alcoholic polyneuropathy. The severity of the clinical manifestations of the disease directly depends on the total dose of ethanol.

Scientists suggest that the toxic effect of ethanol and its breakdown products on neurons is carried out through the activation of glutamate receptors in the spinal cord, excitation of glutamate neurotoxicity, activation of free radical lipid peroxidation processes, and increased production of hormones that cause inflammation. Ethanol helps to reduce the production and disruption of the normal configuration of the proteins of the cellular skeleton of the nerve fiber, slowing down axonal transport. Many representatives of the Asian race have impaired normal metabolism of ethyl alcohol due to the presence of a mutation in the gene that codes for the production of the enzyme aldehyde dehydrogenase. As a result, the level of toxic acetaldehyde in the human body can exceed the norm by more than 20 times.

Acetaldehyde is able to form complexes with normal proteins, turning them into proteins that have a toxic effect on cells. They affect neurons, muscle and liver cells, leading to the development of cirrhosis of the liver. This further exacerbates the severity of toxic alcoholic polyneuropathy.

Ethanol activates microglial cells of the spinal cord, increases the functional activity of the sympathoadrenal and hypothalamic-pituitary-adrenal systems. These changes play a significant role in the formation of increased sensitivity in the spinal cord and in the development of neuropathic pain syndrome. Pain syndrome occurs under the influence of weak stimuli, which previously did not cause pain. The neurons of the peripheral nervous system are more vulnerable to the action of toxic products of alcohol metabolism than the neurons of the central nervous system, which are protected by the blood-brain barrier.

Symptoms of alcoholic polyneuropathy

In patients with toxic alcoholic polyneuropathy, weakly myelinated fibers are predominantly affected. The clinical picture of the disease is dominated by vegetative and sensory disorders. In most patients, the earliest clinical symptoms of the disease are:

paresthesia (sensations of "tingling", "crawling");
numbness in the distal lower extremities;
periodic convulsive twitching of the muscles of the legs and feet.

At the same time or somewhat later, a feeling of "burning" joins, neuropathic pains in the limbs, which are excruciating "burning", "shooting" in nature, intensify at night. Restless legs syndrome may develop. Its clinical basis is an imperative desire to move the limbs due to unpleasant sensations in them, more pronounced at night.

Toxic alcoholic polyneuropathy progresses over several months or years. Symptoms of the disease begin in the distal lower extremities, spread to the proximal legs, lower torso, and in more severe cases, to the upper extremities. In this clinical form, the sensory defect predominates over the motor defect. In half of the patients, even with a long course of the disease, motor disorders do not occur. In other patients, weakness in the extensors of the feet and fingers may join, hypotrophy (reduction in volume) of the muscles of the distal legs may develop. With a long course of the disease, weakness appears in the proximal parts of the legs and hands, and walking is difficult.

With alcoholic polyneuropathy, autonomic dysfunction is often noted. It manifests itself with the following symptoms:

increased sweating of the feet and hands and feet;
trophic disorders;
changes in the color of the skin;
edema;
orthostatic hypotension (lowering blood pressure with a change in body position);
palpitations at rest;
constipation, indigestion.

Violation of the autonomic innervation of internal organs further aggravates metabolic disorders caused by the toxic effect of ethanol and its metabolites. Peripheral autonomic failure increases the risk of sudden death in patients due to painless forms of myocardial infarction.

Neurologists during an objective examination of patients detect violations of pain and temperature sensitivity according to the polyneuropathic type in the form of a decrease or increase in sensitivity. In some cases, signs of allodynia develop (pain due to exposure to stimuli that usually do not cause it). In the early stages of the disease, Achilles reflexes fade or fall out. With further progression of the pathological process, knee reflexes, tendon reflexes from the hands decrease or fall out, weakness and hypotrophy of the muscles of the limbs join.

Along with chronic alcoholic polyneuropathy, neurologists at the Yusupov hospital observe patients whose symptoms of the disease develop acutely or subacutely. In the mechanism of development of this form of alcoholic polyneuropathy, the leading role is played by a deficiency of vitamin B 1 (thiamine) and other B vitamins. When drinking alcohol, thiamine deficiency in the body develops in several ways. Ethanol reduces the absorption of vitamin B 1 in the small intestine, reduces the supply of thiamine in the liver, and reduces its intracellular phosphorylation. This leads to a decrease in the formation of the active form of the vitamin - thiamine diphosphate.

In most patients suffering from chronic alcoholism, there is an inadequate, unbalanced diet, diseases of the gastrointestinal tract develop, which lead to malabsorption. As a result of vitamin B1 deficiency, the incorporation of lipids into myelin decreases, the biosynthesis and metabolism of neurotransmitters are disturbed, zones with lactic acidosis and intracellular calcium accumulation are formed in neurons. They enhance the neurotoxic effect of alcohol.

Diagnosis of alcoholic polyneuropathy

The clinical symptoms of alcoholic polyneuropathy are nonspecific, therefore, when making a diagnosis, the neurologists of the Yusupov hospital evaluate the drug status and nutrition of the patient. Laboratory indicators reflect the degree of damage to the liver tissue due to alcohol intoxication. Patients have elevated levels of hepatic transaminases (aspartate aminotransferase and alanine aminotransferase) or gamma-glutamyl transpeptidase. To clarify the presence of a deficiency of thiamine and other B vitamins, their concentration in the blood serum is studied. Thiamine deficiency is confirmed by a decrease in the transketolase activity of erythrocytes. The study of cerebrospinal fluid does not reveal changes.

The main method for diagnosing alcoholic polyneuropathy is electroneuromyography. This innovative research method allows you to determine the level, nature and degree of damage to peripheral nerves. Alcoholic polyneuropathy is characterized by generalized symmetrical sensory-motor, predominantly distal axonopathy with signs of secondary myelinopathy.

When conducting stimulation electroneuromyography, a decrease in the amplitude of action potentials of sensory and motor nerves can be determined. This reflects the defeat of the axial cylinder of the nerve fiber - axonopathy. There is a decrease in the rate of propagation of excitation along the sensory and motor fibers of all nerves of the limbs, which is a sign of myelinopathy. These changes can be observed in patients who do not have clinical signs of alcoholic polyneuropathy.

In the diagnosis of various clinical forms of alcoholic polyneuropathy, the neurophysiologists of the Yusupov hospital use needle electromyography. It allows you to quantify the parameters of action potentials of motor units and identify signs of denervation in the muscle, which are caused by damage to the axon - fibrillation potentials, positive sharp waves.

The method of electroneuromyography allows you to assess the condition of thick myelinated fibers of peripheral nerves. To diagnose damage to thin fibers of peripheral nerves in the presence of alcoholic polyneuropathy, doctors of functional diagnostics use the following methods:

quantitative sensory testing;
laser evoked potentials;
evoked potentials for thermal stimulation;
study of intraepidermal nerve fibers.

In cases that are difficult to diagnose, neurologists collectively establish a diagnosis and individually approach the choice of a method of therapy.

Treatment of alcoholic polyneuropathy of the lower extremities

Given the multifactorial nature of the mechanisms of development of alcoholic polyneuropathy, combined damage to the liver and gastrointestinal tract, neurologists at the Yusupov Hospital conduct a complex therapy for the disease. Patients are observed by a neurologist, internist, hepatologist, gastroenterologist. In most cases, the prognosis for alcoholic polyneuropathy is favorable. Neurological functions are restored, but patients retain residual effects of peripheral nerve damage. Treatment of alcoholic polyneuropathy requires a long period of time because axonal regeneration and repair of collateral neurons are slow.

An obligatory condition for the effective treatment of alcoholic polyneuropathy is the complete rejection of the use of alcoholic beverages, the restoration of a complete balanced diet with a sufficient amount of vitamins and protein, and the physical rehabilitation of the patient.

To relieve pain in alcoholic polyneuropathy, neurologists use from the group of antidepressants and anticonvulsants, as well as their combinations. Among antidepressants, the most effective drugs are tricyclic antidepressants (amitriptyline) and serotonin and noradrenaline reuptake inhibitors venlafaxine and duloxetine. An alternative is anticonvulsant therapy - pregabalin, gabapentin.

In the treatment of alcoholic polyneuropathy, doctors of the neurology clinic use drugs from the group of antioxidants - alpha-lipoic acid. It directly removes free radicals, restores antioxidants (glutathione, vitamins E and C; reduces the production of free radicals. Considering that a decrease in the concentration of thiamine in the blood is observed in 40–80% of people with chronic alcoholism, doctors at the Yusupov Hospital prescribe to patients suffering from alcoholic polyneuropathy, combined preparations of B vitamins. They include thiamine, pyridoxine (vitamin B 6) and cyanocobalamin (vitamin B 12).

In order to establish a diagnosis and undergo an effective course of therapy for alcoholic polyneuropathy, call the Yusupov hospital. A contact center specialist will book you an appointment with a neurologist at a convenient time.

Bibliography

ICD-10 (International Classification of Diseases)

*The information on the site is for informational purposes only. All materials and prices posted on the site are not a public offer, determined by the provisions of Art. 437 of the Civil Code of the Russian Federation. For exact information, please contact the clinic staff or visit our clinic. The list of paid services provided is indicated in the price list of the Yusupov hospital.

Alcoholism gradually, painfully destroys a person. Ethanol is a very toxic substance, and its breakdown products cause irreparable damage to all body systems. Alcoholism leads to a weakening of the immune system, deterioration of mental health, complete personal degradation.

- one of dozens of diseases arising from alcohol abuse.

- a dangerous disease that manifests itself in intoxication of the nervous system. But not only alcoholism can cause polyneuropathy - diabetes mellitus or an infectious infection can provoke this disease.

In the first two cases, the disease develops in stages, with a gradual worsening of symptoms. In about 10% of cases, polyneuropathy develops very abruptly and can cause serious damage to the body in just a few days. But do not get upset in advance - medical intervention, carried out on time - in the early stages of the disease, will allow you to completely cope with it. Otherwise, it may become chronic.

Alcoholic polyneuropathy according to ICD-10 has code G62.1

Symptoms of alcoholic neuropathy

Symptoms come on slowly, so diagnosing neuropathy is not easy. The main symptom of the course of the disease is the defeat of the patient's nervous system.

At first, a person experiences mild numbness in the fingers and toes. After that, the discomfort spreads further to the limbs. Blood circulation worsens, after which the patient may feel cold in the legs.

Muscles gradually atrophy, their visual reduction can be observed with your own eyes. Severe convulsions become more frequent, especially at night. The skin on the lower extremities turns blue, acquires a "dead" color.

Further development of the disease leads to complete paralysis of all limbs. As a result, a person cannot move, becomes physically incapacitated. Often, from this point on, most patients spend all their time without getting out of bed.

The destructive effect of alcoholic polyneuropathy of the lower extremities does not end there - the body continues to weaken, a person may experience phantom pain, as is often the case after amputation. Mental health disorders can also exacerbate the course of the disease.

Neuropathy is also not limited to problems with the limbs - its influence extends to visual, respiratory functions and the cardiovascular system. But first of all, it is the patient's legs that are at risk - everyday deterioration increasingly interferes with motor function.

Regardless of the causes of neuropathy, its main symptoms are similar: convulsions, gradual muscle atrophy, and as a result - paralysis, the development of further adverse symptoms may differ in individual situations.

During medical intervention and treatment of the disease, the symptoms gradually recede in the reverse order, although in some situations, after the completion of treatment, some initial signs may remain.

Diagnosis of alcoholic polyneuropathy

First of all, in a medical institution, the doctor collects information about the patient, his habits, lifestyle. A check is made for extraneous factors, diseases that could provoke polyneuropathy, after which the patient is examined by a neurologist to detect primary signs of the disease.

Electroneuromyography(ENMG) - a procedure that allows you to determine the degree of damage to the nervous system. It reveals how much the disease has spread, whether the peripheral nerves are affected and what stage of the disease is acute or chronic. ENMG is able to detect muscle dystrophy, tunnel syndrome, amyotrophic syndrome. Regular electroneuromyography will help in monitoring treatment and monitoring the recovery process.

In some cases, carry out tissue biopsy of the nervous system. This more complex procedure is able to identify a number of other serious diseases, and more accurately diagnose polyneuropathy. These methods will quickly identify the disease, its degree, distribution and complication, which will help to start treatment as quickly as possible.

In most cases, the treatment of alcoholic polyneuropathy takes place at home. In the last stages of the development of the disease, when the patient's life is at risk, the course of treatment is carried out in a hospital.

Depending on the cause of the disease, various etiological methods are used to determine the first steps in recovery. If this reason is alcoholism, then the main factor, without which all further treatment will be useless, is a complete rejection of alcohol. Namely, it is necessary to completely and forever abandon alcohol, even in small quantities.

Unfortunately, it will be impossible for a person who abuses alcohol, especially for a long time, to get rid of this addiction on his own. Here the help of a psychotherapist, coding methods and support from relatives and friends will serve. The combined use of these factors minimizes the likelihood of disruptions.

The next step towards returning to the human condition will be the resumption of the correct regime and a healthy lifestyle. A well-thought-out daily schedule, healthy nutrition and physical activity will significantly speed up the recovery of the patient. With alcoholic neuropathy, emphasis should be placed on vitamin-rich and protein foods. But you should not rely on your awareness in everything - it is necessary to draw up a detailed diet individually for everyone and only a doctor can do this.

Treatment with drugs

The above factors are combined with medication treatment.

In the treatment of alcoholic neuropathy, a number of drugs are used, which is divided into several main groups:

Vitamin complex. It is important for the patient to make up for the lack of vitamin B in the body. Pentovit and Complivit preparations, which have a positive effect on the nervous system, will help in this.
Neurotropic drugs.
Nootropic drugs. They help the development of mental activity, reduce the effect of toxins on the brain and improve the mental state of the patient (Piracetam, Phenibut, Glycine).
Antidepressants. This type of drugs also have a positive effect on the psyche and contribute to the complete rejection of alcohol by a person (Amitriptyline).
Metabolic drugs. Improve metabolism. They are taken by patients during recovery in a complex, together with physiotherapy.

In case of liver damage, hepatoprotective drugs and antioxidants can be prescribed for general strengthening of the body. Additionally, it is possible to use traditional medicine recipes. This is a tincture of cloves, milk thistle seeds, olive oil, carrot juice.

Non-pharmacological treatment of neuropathy

Physiotherapy and related procedures play an important role in the treatment of the patient. electrical stimulation spinal cord and nerve fibers are often included in this category. Even such procedures as ordinary massage, physiotherapy exercises and acupuncture contribute to the fastest recovery.

On the territory of our country, magnetotherapy is widely practiced, although there is no exact scientific confirmation of the effectiveness of this method. Only as an additional treatment magnetotherapy is beneficial, although it has its fans and positive reviews. In US clinics, the use and sale of all products related to magnetotherapy is prohibited at the state level.

Emotional Support- both therapeutic and at the household level, an important factor in recovery. A measured domestic atmosphere, a change of environment and new acquaintances will speed up drug treatment and become a good prevention of alcoholic neuropathy.

Fulfillment of conditions for prevention: exclusion of alcohol from life, visits to health centers, regular rest and minimized stressful situations will make you forget about the disease.

There are numerous cases when patients in critical condition, who are on the verge of disability, fully recovered.

Complications of alcoholic neuropathy

The nervous system is the most complex structure of the human body. It is responsible for the proper functioning of organs, mental and motor abilities, genesis, and also affects other body systems. Accordingly, in case of violation and damage to the nervous system, the entire body will suffer: organ failure and even complete cardiac arrest are possible. The disease can affect various nerves, for example, the optic nerve.

Muscle atrophy in the later stages can lead to permanent and irreversible disability. Problems with the respiratory system will also make themselves felt. If the patient continues to drink alcohol in the later stages, then a sharp deterioration in memory, mental abilities is likely, and in the end this will lead to dementia.

This is a neurological disease in which there is damage to the peripheral nerves. According to studies, this disease is observed in 85% of people suffering from alcohol dependence. Both men and women can suffer from the disease.

Causes

Experts identify quite a few reasons why alcoholic polyneuropathy can develop. The most common cause is the constant toxic effect of ethanol products on the body, in particular on the nerve endings.

Such an effect inhibits metabolic processes, resulting in a violation of the flow of blood and nutrients to nerve impulses.

The central nervous system also suffers from the negative effects of acetaldehyde, a breakdown product of ethyl alcohol. Experts say that low-quality alcohol poses the greatest health hazard, as it may contain prohibited chemical compounds that lead to irreversible processes in the body.

In the case of prolonged alcohol use, a person has pronounced disturbances in the liver, which is a link with polyneuropathy. The immune system also suffers greatly from ethanol, antibodies develop at a high rate in the body, which inhibit their own nerve tissues.

Often, alcoholic polyneuropathy develops due to a deficiency in the body of vitamin B, the absence of which occurs in the case of a small amount of nutrient intake and poor absorption into the intestine.

If there is a lack of thiamine, then alcohol cannot completely leave the body, which causes its long-term negative effect on all organs.

If a person is in a strong alcoholic intoxication, while lying in the same position for a long time, squeezing of some internal organs begins, a nerve is damaged. Other reasons why the disease develops are excessive hypothermia, the ingress of harmful substances and viruses into the body.

Forms

The disease proceeds in different ways, it also occurs for various reasons, hence the experts identified several forms of alcoholic polyneuropathy.

touch- characterized by significant pain in the limbs, a person feels constant chills of the feet, numbness, sometimes burning, often there are cramps in the calves of the legs, in some places it even hurts to touch the feet. In the palms and feet, there is also a loss of sensation, the patient may feel a dull pain. The sensory form occurs as a result of a violation of the vegetative-vascular system, excessive marbling, acrocyanosis can be observed on the skin, weakness is noted in the tendons.

Motor. With this form, a person has a violation of peripheral nerves. The lower extremities also suffer, in particular the peroneal and tibial nerve. In the event of a tibial nerve disorder, a person cannot normally bend the foot, move his fingers, it is impossible to bend the foot inward, and also walk on toes. Violation of the peroneal nerve leads to the inability to straighten the feet and fingers. Muscles in this area atrophy, hypotension of the feet occurs.

Mixed. If a person has mixed alcoholic polyneuropathy, in this case, violations of the motor, sensory apparatus occur simultaneously. The patient becomes pronounced numbness of the limbs, there is a complete paralysis of the feet and hands, severe or mild pain, and there is a decrease or increase in the sensitivity of nerve endings, extensor function suffers to a greater extent.

Atactic. The patient has a pronounced disturbance in gait, coordination suffers greatly, the legs and arms become numb, they practically do not feel anything, when you press the sole of the foot or the palm, a stabbing pain is felt.

The disease according to the form of the course is also divided into chronic and acute:

The chronic form is characterized by the fact that the disease develops slowly, pathology gradually develops in the limbs. This form is most common, usually a person begins to suffer after a year of alcohol addiction.
The acute form develops quickly, but is quite rare. For a complete atrophy of the limbs, a person just needs not to leave the state of intoxication for a month and a half.

Stages:

The first stage is characterized by the absence of symptoms of the disease, the clinical picture of the disease is also not visible, polyneuropathy can be detected only if you pass the necessary tests and undergo some examinations.
The second stage is easily detected by a doctor's examination, as well as on the basis of complaints from the patient. There are no visible defects of the limbs yet.
The third stage is expressed by a visual change in the limbs, pain, numbness, a person cannot walk normally.

Alcoholic neuropathy: symptoms and early diagnosis

The first thing a person feels is weakness in the muscles, usually manifested in the morning after sleep, first the lower limbs go numb, after a few minutes the hands begin to go numb. In some cases, numbness affects all limbs at once. The patient first sharply decreases, after which the tendon reflex stops completely, the Achilles reflex is most susceptible, and muscle tone worsens.

Alcoholic neuropathy in its advanced form is manifested by such symptoms as: weakness in the muscles, paresis of the lower extremities, paralysis of the hands or feet, a person may not feel objects.

Sometimes the patient may complain of a deterioration in visual reflexes. All of the listed signs of the disease are not permanent, they can last for several days, then completely disappear for one or two days, then repeat again. At the last stage, urination worsens, a person suffers from nervous disorders, breathing is disturbed, tachycardia, bradycardia, arrhythmia appear, and blood pressure drops sharply. A person can feel pain even with such forms of the disease, when there is enough vitamin B and it settles in the foot. The nature of pain is aching, burning sensations appear.

Along with this, a person’s gait is disturbed due to the fact that the feet become too sensitive, the foot cannot be bent inward, marbling, cyanosis, tingling, numbness in the calves, and cramps are visible on the legs.

Alcoholic neuropathy is not the only disease in which severe numbness of the extremities appears, such a disease has clones, namely diabetic polyneuropathy:

Diabetic polyneuropathy- characterized by blockage of blood vessels in the extremities. A person with such a disease, depending on the stage, feels periodic numbness of the hands or feet, the muscles become weak, the long sciatic, femoral, and ulnar nerves are affected. People with diabetes feel the same pain in their legs as people with alcoholics, they have redness of the skin, cyanosis of the feet, the skin becomes dry, ulcers, rotting wounds form. Such patients should not drink alcohol in any case. This disease is terrible because, unlike alcoholic polyneuropathy, diabetic polyneuropathy cannot be cured, it slowly progresses.
Neuropathy of the lower extremities- the disease is characterized by a constant attack of numbness of the limbs, especially after a long walk, at this time the legs begin to break out, twist, you want to constantly touch them, massage them. This happens as a result of compression of the peripheral nerves.
Upper limb neuropathy- the disease is similar to neuropathy of the lower extremities, differs only in that the first disease can affect several nerves at the same time, which can lead to a temporary loss of hand sensitivity.

Early diagnosis

In order to identify the disease in the early stages, the patient should have symptoms such as flaccidity of the tendons, weakness in the muscles, only on the basis of the clinical picture of the first signs can an analysis of the disease be carried out. This usually happens when the patient is examined by a doctor at the first appointment.

Electroneuromyography allows you to identify the first signs of the disease, determines how much the disease has developed, and also whether the patient has inflammation of the nerve. For a different examination, the doctor may order a biopsy of the nerve fiber. Such an examination has to be done to exclude polyneuropathy of another type.

Alcoholic neuropathy and principles of treatment

The disease can appear only after prolonged use of alcohol. Depending on how severe the symptoms of the disease are, with what complications it all goes away, appropriate treatment is prescribed.

Alcoholic neuropathy is most effectively treated at an early stage. When prescribing various drugs, specialists, first of all, try to restore the lost function of nerve endings, improve blood circulation in this area. In this case, the doctor needs to carefully prescribe drugs to avoid allergies.

The following drugs are prescribed:

Among non-drug methods, physiotherapy is distinguished, in this case, electrical stimulation of nerve endings occurs. The doctor also prescribes massage to quickly restore muscle activity. You should engage in recreational physical exercises, take courses of acupuncture.

Alternative treatment

Folk remedies are good for complex treatment of the disease. There are a large number of recipes for such an ailment, consider the most effective of them. You can make a cocktail based on fresh carrot juice (100 g), add one yolk, a few drops of olive oil, two teaspoons of honey.

The ingredients are mixed in a blender, after which they are consumed twice a day before meals. Well helps infusion of bay leaf and fenugreek seeds (3 tablespoons). The mixture is brewed in a thermos for four hours.

Use the infusion twice a day. This medicine helps to speed up blood circulation through the vessels, normalizes sugar levels. Locally, you can lubricate the limbs with olive oil with the addition of dry St. John's wort. The grass is poured with hot oil, insisted for 15 hours, filtered. The tool can make compresses on the feet.

Forecast

Alcoholic neuropathy is well cured in the early stages. In advanced cases, you can become disabled, so it is so important to visit a specialist already at the first symptoms of the disease. The effect of treatment is observed in those patients who asked for help in time. It is necessary to be patient, since the treatment will be long, stubborn, you will need to eat right, the most important thing is not to drink a drop of alcohol.

Alcoholic polyneuropathy can cause a number of complications, namely:

It should be remembered that at the first symptoms of such a terrible disease, you must consult a doctor, otherwise you can lose limbs for the rest of your life.

Prolonged and continuous alcohol abuse leads not only to the complete degradation of a person's personality, but also affects the occurrence of various diseases of internal organs. Alcoholic polyneuropathy also belongs to such ailments, according to statistics, it occurs in 10% of patients suffering from alcohol dependence, regardless of whether it is a woman or a man.

Causes of the development of alcoholic polyneuropathy

The toxic effect of alcohol breakdown products adversely affects the peripheral nervous system, disrupts metabolic processes and the transmission of impulses, which becomes the basis for the symptoms of the disease. Pathological changes affect all departments in the spinal cord and brain.

Polyneuropathy from alcohol abuse develops in the last stages of the disease, the cause of its occurrence is:

The toxic effect of ethyl alcohol and its decay products on nerve fibers;
Deficiency of the B group of vitamins. The lack of this group of vitamins is due to monotonous nutrition, impaired functioning of liver cells and a decrease in the absorption of nutrients from the intestinal mucosa. A small amount of thiamine does not allow alcohol to be fully oxidized, which only enhances its toxic effect and reduces the rate of metabolic processes.
Violation of microcirculation in the structure of the nerve fiber.

The risk of polyneuropathy increases several times with the use of surrogate alcohol, various methylated spirits and chemical alcohol-containing liquids.

Such liquids have the most toxic effect on the liver, due to which B vitamins are quickly destroyed and a complete metabolic disorder occurs.

Course of the disease

Alcoholic polyneuropathy in most patients develops gradually, but due to the constant presence in alcoholic dope, a person does not pay attention to the appearance of the first clinical signs.

The acute onset of the disease causes the intake of large doses of alcohol for several days.

Patients begin to pay attention to their health when there is a pronounced weakness in the legs and the inability to move.

Very often, alcoholic polyneuropathy is a harbinger of a more serious disease such as
which is very difficult to treat.

Alcoholic polyneuropathy of the lower extremities is the most common manifestation of the disease in the initial stage.

Complaints of patients with alcoholic polyneuropathy

Attention to the fact that health problems appeared at the initial stage of polyneuropathy, the patient can only pay attention while being in a sober state. Typically, patients experience the following symptoms:

Convulsive contractions of the muscles in the toes.
Numbness and goosebumps in the limbs - paresthesia that appeared after a night's sleep. Sensitivity in the legs is restored in a few minutes or hours.
Pain in the feet, calf muscles. Soreness appears first at night, as the disease develops, it becomes permanent.
A characteristic sign is soreness and discomfort with slight palpation of the calf muscles.
Often painful cramps develop in the muscles of the leg.
The lower extremities are periodically cold even on summer days.
As the disease progresses, there is persistent weakness in the legs, and then in the arms.
In rare cases, the patient complains of oculomotor disorders.

Clinical signs of the disease increase as more and more nerve fibers are involved in the pathological process. Symptoms of the disease can also undergo a reverse development, provided that alcohol-containing liquids are completely abandoned.

Manifestations of alcoholic polyneuropathy

In alcoholic polyneuropathy, motor disorders come to the fore. A cock's gait appears due to dysfunction of the extensor muscles in the foot.

Atrophy of the calf muscles develops rapidly, which is manifested by weight loss of the lower extremities. The muscles of the hand are included in this pathological process much later than the leg muscles.

Due to the violation of sensitivity, it seems to the patient that the surface of the floor has become soft.

The structure and color of the skin also changes - the limbs become marbled, the skin is dry, brittle nails increase, excessive sweating may occur, the hairline on the legs disappears, and trophic ulcers and edema appear at the end of the disease.

Paresis and paralysis at the initial stage last a short period of time, then they can significantly limit the patient's mobility.
With further toxic damage to the nerve fibers, the vagus nerve is affected, due to which shortness of breath and tachycardia appear.
A feature of the course of polyneuropathy of alcoholic genesis is its combination with amnesic syndrome, which is manifested by a lack of memory for ongoing events, disorientation in space and time.
On examination, the doctor pays attention to the violation of sensitivity in the calf muscles, on the arms and legs, this is recorded as the absence of reflexes in the area of putting on gloves and socks.
Damage to the nerves begins with the lower sections and gradually spread to the entire body. This feature explains the appearance of the first symptoms of the disease in the lower extremities.

Alcoholic polyneuropathy must be distinguished from diabetic polyneuropathy. Diabetic polyneuropathy has similar clinical symptoms, sometimes is the first sign of diabetes. The diagnosis is made on the basis of blood tests and instrumental examinations.

Treatment of alcoholic polyneuropathy

Success in the treatment of alcoholic polyneuropathy in general and in the treatment of polyneuropathy of the lower extremities depends on how much and how quickly the patient can stop drinking alcohol.

Medical treatment consists of groups of drugs used in courses. First of all it is:

Appointments of thiamine and other B vitamins in injections and tablet form. The complex of vitamins is contained in such medicines as Trigamma, Kombilepen, Neurorubin - forte.
Drugs that improve microcirculation and metabolic processes in the body. Of the modern drugs, this group includes Thioctacid, Dialipon, Thiolepta.
For pain syndrome, anti-inflammatory drugs and analgesics diclofenac, ibuprofen, baralgin, smazgan are used.

Help to quickly restore the motor sphere in a state and traditional medicine about which you can read in more detail used in conjunction with medicines prescribed by a doctor.

A vitamin cocktail is prepared from one fresh chicken egg, two tablespoons of honey and olive oil. This mixture is whipped and 100 grams of fresh carrot juice is added to it. The cocktail is taken twice a day.
Kefir mixed with seeds and fresh parsley. Two tablespoons of seeds and parsley are crushed, poured with a glass of kefir and drunk 40 minutes before breakfast. The mixture perfectly removes toxins and saturates the body with vitamins.
From external means, baths prepared from the infusion of coniferous branches and from the pods of red hot pepper are used. Keep your feet in this liquid for up to 30 minutes a day, then put on warm socks.

It will help to cope with alcohol addiction during the treatment of the disease with soothing herbs - motherwort, thyme, valerian.

Positive dynamics can be achieved only after several months of therapy with a complete rejection of alcohol. Equally important is the proper nutrition and physical exercises aimed at strengthening the muscles.

Forecast

Without treatment, the symptoms of alcoholic polyneuropathy increase, for the patient this can result in paralysis of the limbs, mental disorders, damage to the cerebellum, in which functional disorders of coordination of movements are observed.

- Multiple lesions of peripheral nerves in alcoholism. It usually occurs in the later stages of an alcoholic disease. Accompanied by muscle weakness, sensory disturbances and ataxia. There may be increased sweating. Edema, changes in temperature and color of the distal extremities are often observed. In some cases, mental disorders occur. It develops gradually, rarely acutely. With treatment, the symptoms are reduced within a few months or years. Vitamin therapy, metabolic therapy and physiotherapy are carried out. With the refusal of alcohol, the prognosis is quite favorable.

ICD-10

G62.1

General information

Alcoholic polyneuropathy is a disease accompanied by simultaneous damage to a large number of peripheral nerves. According to statistics, polyneuropathy, accompanied by neurological symptoms, is detected in 10-30% of patients suffering from alcoholism. When conducting a comprehensive electromyographic study, certain disorders indicating the presence of an asymptomatic form of alcoholic polyneuropathy are detected in most chronic alcoholics.

Men suffer from clinical forms of polyneuropathy more often than women. In most cases, there is a chronic or subacute course. Sometimes the disease develops acutely, against the background of hard drinking or hypothermia. The duration of the disease can vary significantly and ranges from several months to several years. The outcome largely depends on timely treatment and refusal to drink alcohol. Alcoholic polyneuropathy often causes disability, which can later be removed in case of satisfactory treatment results. Treatment of this disease is carried out by neurologists in cooperation with specialists in the field of narcology.

Reasons for development

The main reasons for the development of alcoholic polyneuropathy are: the toxic effect of alcohol on the body, a lack of B vitamins, malnutrition, an increase in blood sugar, and hereditary characteristics of the patient's metabolism. Pathology, as a rule, occurs in patients with the third, less often with the second stage of alcoholism. The likelihood of symptoms of polyneuropathy increases when taking low-quality alcohol, denatured alcohol and all kinds of chemical liquids containing ethyl alcohol.

With the constant use of alcohol in the patient's body, a toxic intermediate product of the breakdown of ethanol, acetaldehyde, accumulates. It has a destructive effect on all organs and tissues, including the axons of nerve cells. The rate of accumulation of acetaldehyde is largely determined by the hereditary characteristics of metabolism - the body's ability to produce acetaldehyde dehydrogenase and alcohol dehydrogenase (enzymes involved in the processing of ethanol).

The situation is aggravated by a deficiency of vitamin B1, which is involved in the transmission of nerve impulses, acts as an antioxidant, prevents the destruction of cells (including cells of the nervous tissue) and affects the processing of alcohol in the liver. The lack of vitamin B1 is due to a whole range of reasons, including insufficient or unbalanced nutrition associated with a decrease in appetite, hard drinking, financial difficulties and inattention to one's health; deterioration of absorption of vitamin B1 in the intestine; dysfunction of liver cells, etc.

Classification

All disorders develop gradually, pathological changes in the peripheral nervous system occur long before the first clinical symptoms appear. Taking into account the severity of these changes, as well as the presence or absence of clinical symptoms, 4 stages of polyneuropathy are distinguished:

0 stage- no polyneuropathy. Signs of pathology are not detected even during special studies (electromyography, quantitative vegetative and sensory testing).
1 stage asymptomatic polyneuropathy. There are no clinical signs, but special studies indicate the presence of pathological changes.
2 stage clinically significant polyneuropathy. The disease can be diagnosed on the basis of complaints and objective examination, there is no pronounced functional defect.
3 stage- polyneuropathy with severe functional impairment. Ability to work is reduced or lost.

Symptoms of alcoholic polyneuropathy

The first manifestations of alcoholic polyneuropathy are usually paresthesias - sensory disturbances, manifested by a feeling of slight numbness, crawling and tingling. Patients complain that they "have served their leg" during a long stay in a sitting position or "lay their hand" in a dream. In the initial stages of polyneuropathy, paresthesias appear only when they are in an uncomfortable position for a long time, therefore, they often do not cause particular anxiety in patients.

Subsequently, the frequency of occurrence and severity of paresthesia increases. Temperature and pain sensitivity decrease, numbness becomes permanent and gradually spreads in the proximal direction. Patients with severe polyneuropathy say that their hands and feet seem to be wearing gloves and socks that reduce sensitivity. When walking, a feeling of movement "on an air cushion" is created. When working with hands, objects are poorly perceived by touch. The symptom can progress both abruptly (about a month) or gradually (over a year or more).

Paresthesias may be associated with progressive muscle weakness, which also spreads upward. In some cases, muscle weakness prevails in the clinical picture, and paresthesias fade into the background. Sensory and muscle disorders in the lower extremities are detected in almost all patients. The upper limbs are involved in the process in about 50% of cases. With the defeat of thick fast-conducting nerve fibers, not only temperature and pain, but also vibration sensitivity, as well as muscular-articular feeling, suffer. In severe cases, paralysis occurs.

Diagnostics

Neurological examination in the early stages reveals an increase in tendon reflexes, in the later stages - a decrease. Skin and pain sensitivity is reduced. Muscle tone is reduced, in the presence of muscle disorders, atrophy develops rapidly. Sometimes contractures form in the distal extremities. Often there is a lesion of the calf muscles, accompanied by increased pain on palpation of the muscles and pressure on the area of passage of the nerves that innervate this anatomical region. Electromyography, quantitative vegetative and sensory testing are used as an additional method to confirm the diagnosis of polyneuropathy.

Treatment of alcoholic polyneuropathy

Treatment includes a complete abstinence from alcohol and good nutrition. Patients are prescribed vitamins of group B in tablets and injections, antioxidants, antihypoxants, agents to improve microcirculation and nerve conduction. With intense pain syndrome, analgesics are used, sometimes anticonvulsants and antidepressants are used. Spend