Alcoholic Neuropathy

About eight years ago I began to experience tingling and numbness in my hands.  The numbness would wake me up at night and my hand(s) would be completely "dead".  At the time I believed it to be carpal tunnel syndrome as my job required extensive typing.  I don't type as much now but the numbness and tingling has become more frequent and recently my legs started tingling as well.  This occurred after drinking the night before.  Although I don't drink on a daily basis I have been a heavy drinker most weekends for the past 25 years (generally more than five drinks in a day and I weigh 115 pounds).  I have a very high tolerance to alcohol and often have had blackouts and bad hangovers.  I am also a vegetarian so I am wondering if a combination of the heavy drinking and a B12 deficiency could be causing peripheral neuropathy.  How much and at what frequency of alcohol is considered excessive enough to be a contributing factor in PN?  Other symptoms include incontinence, a rapid heavy heartbeat after drinking, a tickle in my throat at night that makes me cough, muscle cramps in my feet and calves, and I'll wake up in a dripping sweat, mostly on my chest area, even when it's not hot.  Most of these are worse after drinking.

[rod44]

You will need to get the Neurological symptoms checked by a Neurologist, you have many PN symptoms but you will need a Doctor to get adefinitive  DX

As most of your symptoms are related to your drinking and I think you know that you have a problem with your drinking the best advice is to eliminate the cause of your problems, you need to stop drinking, that in it self can be a problem. You need to talk to your GP about this. Detox needs to be medically supervised, I know from my own experience that dealing with the physical withdrawals is only part of getting sober. You will need to deal with the emotional issues, this was difficult and I know that I could not get sober on my own. We have an on-line support group here on MedHelp, you are welcome to join us.....    

http://www.medhelp.org/forums/Alcoholism/show/158?camp=msc

[Red_Star]

A male drinking more than 8 pints of usual strength lager (5%abv) per week, on a routine basis would be classified as an alcoholic. A female drinking more than 1.5 bottles of wine (13%abv) per week on a routine basis would be classified as an alcoholic.

Chronic alcoholism is often associated with malnutrition and nutritional and vitamin deficiencies, including vitamin B12, vitamin B1 (thiamin), folate and other B vitamins. It may be hard to distinguish nutrition related neuropathies from alcoholic neuropathy. Alcoholic neuropathy is due to ethanol having a toxic effect on the peripheral nerves.

Some essential dietary requirements, which could be missing from a vegetarian diet if it isn’t carefully planned, include protein, minerals (including iron, calcium and zinc), vitamin B12, and vitamin D. Vitamin B12 is essential for the maintenance of the myelin sheath that protects nerve cells from damage.

[Dr Sharma]

Hi. The diagnosis is based on history of prolonged and excessive alcohol intake, clinical signs and symptoms, electrophysiological testing. Certain criteria suggest a minimum of 100 ml, ethyl alcohol, 3 lts of beer or 300 ml of spirits per day for 3 years will cause this. Confirmation would require sensory conduction studies, motor conduction studies and needle electromyography. Liver involvement associated with chronic alcoholism and nutritional deficiency would require liver function testing and look for macrocytic anemia. csf may show increased protein level. Treatment includes stopping further damage by abstinence, nutritionally balanced diet supplemented by all B complex vitamins and rehabilitation. Consult a neurologist immediately. Hope this helps. Take care.

[stufflikethat]

Thanks, rod44.  I'll check out the forum you suggested.

[stufflikethat]

Red_Star:  Interesting, I haven't seen that weekly "criteria", usually only daily (i.e. more than two drinks a day every day).  I am a pretty careful vegetarian, but never worried too much about b12 since I do eat eggs and dairy and I know it is stored in the body for a long time, but since alcohol can also interfere with absorption it may be an issue.

DrSharma:  Thanks for your reply.  Can you tell me why the symptoms would be worse for a day or two after drinking and then improve?  If it's the myelin sheath that has been stripped or the nerves actually damage, wouldn't that have a constant effect?  As I mentioned I don't drink daily but maybe the long term exposure over a couple of decades has gradually has had the same effect.  I have an appointment with my GP to at least get some initial bloodwork done to check on vitamin deficiencies and whatever other tests she can do.  I just don't want this to get to the point where the pain starts as I've read many people with PN have!  

Thanks again to everyone who's replied!