Autonomic and Peripheral Neuropathies in Patients With Chronic Alcoholism: A Dose-Related Toxic Effect of Alcohol

doi:10.1001/archneur.1995.00540250049012

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Vol. 52 No. 1, January 1995

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Autonomic and Peripheral Neuropathies in Patients With Chronic Alcoholism

A Dose-Related Toxic Effect of Alcohol

Roser Monforte, MD; Ramon Estruch, MD; Josep Valls-Solé, MD; Josep Nicolás, MD; Jaume Villalta, MD; Alvaro Urbano-Marquez, MD

Arch Neurol. 1995;52(1):45-51.

Abstract

Objective
To assess autonomic and peripheral nervous system function inpatients with chronic alcoholism.

Design
A cross-sectional study.

Patients
A consecutive sample of 107 alcoholic patients and 61 controls.

Main Outcome Measure
For autonomic assessment, heart rate variations during deepbreathing and Valsalva maneuver and on standing were measured.Blood pressure response to standing up and to sustained handgripwere also evaluated. For assessment of the peripheral nervoussystem, an electrophysiologic examination was performed.

Results
Alcoholic patients exhibited reduced heart rate variabilitycompared with controls (P<.01, on all parasympathetic tests),whereas no differences in the mean values of the blood pressureresponses between both groups were found. Twenty-six patients(24.3%) had criteria of autonomic neuropathy, and 34 (32%) hadelectrophysiologic criteria of peripheral neuropathy. None ofthe controls exhibited criteria of autonomic neuropathy, andonly one had criteria of peripheral neuropathy. The estimatedtotal lifetime dose of alcohol correlated inversely with theparasympathetic indexes (r=–.48 to –.51; P<.001on all parasympathetic tests) and the sensory potential amplitudesof upper and lower limbs (r=–.43; P<.001, both limbs).Finally, a significant correlation between autonomic and peripheralneuropathies was observed (P=.01). By contrast, these lesionswere not related to age, nutritional status, or other alcohol-relateddiseases.

Conclusions
Autonomic and peripheral neuropathies are common among hospitalizedalcoholic patients. Alcohol appears to be toxic to autonomicand peripheral nerves in a dose-dependent manner.

Author Affiliations

From the Alcohol Unit, Departments of Internal Medicine (Drs Monforte, Estruch, Nicolás, Villalta, and Urbano-Marquez) and Neurology (Dr Valls-Solé), Hospital Clinic, University of Barcelona (Spain).

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