Alcohol-induced neuropathy

A 60-year-old man presents with pain characterized as pins and needles on his soles extending up to his knees. He also complains of weakness, and has had two falls in the last 2 months. The symptoms have been gradually getting worse over the last 6 months. He appears very cachectic and reports a very heavy alcohol use for the last 30 years. 1. What are some of the epidemiologic considerations for this disease? What is the financial burden it imposes on society? Alcohol is one of the most commonly used substances in the world, and the abuse of this toxin closely mirrors in incidence. Consequently, the myriad detrimental effects to the body result in significant morbidity and mortality. From the notable increase in fat deposition, to pains of alcohol-induced gout, alcohol-induced neuropathy (AIN) is the most common. The true incidence of this condition is difficult to ascertain due to the varying definitions employed for AIN in the different studies. Definitions set forth by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) estimate that neuropathy is present in 25-66% of defined “chronic alcoholics” when using clinical and electrodiagnostic criteria. [1] When evaluating the risk factors for this condition, there appears to be some form of genetic component. Pessione et al demonstrated an increased risk in people with a parental history of alcoholism. [2] AIN is more common in women compared to men. [3] Data investigating this phenomenon suggests that peripheral nerves among females are at increased sensitivity to the toxic effects of this chemical. [4] Given that the risk of developing alcoholic neuropathy is associated with the duration and extent of total lifetime consumption of alcohol, it is not surprising that it is more prevalent in elderly patients. Most people present with symptoms of the disease between the ages of 40-60.