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Meta-Analysis
. 2019 Dec;266(12):2907-2919.
doi: 10.1007/s00415-018-9123-1. Epub 2018 Nov 22.

Alcohol-related peripheral neuropathy: a systematic review and meta-analysis

Thomas Julian  1 , Nicholas Glascow  1 , Rubiya Syeed  1 , Panagiotis Zis  2   3
Affiliations
Meta-Analysis

Alcohol-related peripheral neuropathy: a systematic review and meta-analysis

Thomas Julian et al. J Neurol. 2019 Dec.

Abstract

The primary aim of this systematic review was to establish the prevalence, character, and risk factors of peripheral neuropathy amongst chronic alcohol abusers and to identify the most appropriate management strategies. In this review, possible pathogenetic mechanisms are also discussed. A systematic, computer-based search was conducted using the PubMed database. Data regarding the above parameters were extracted. 87 articles were included in this review, 29 case-control studies, 52 prospective/retrospective cohort studies and 2 randomised control trials, 1 cross sectional study, and 3 population-based studies. The prevalence of peripheral neuropathy amongst chronic alcohol abusers is 46.3% (CI 35.7- 57.3%) when confirmed via nerve conduction studies. Alcohol-related peripheral neuropathy generally presents as a progressive, predominantly sensory axonal length-dependent neuropathy. The most important risk factor for alcohol-related peripheral neuropathy is the total lifetime dose of ethanol, although other risk factors have been identified including genetic, male gender, and type of alcohol consumed. At present, it is unclear what the pathogenetic mechanisms for the development of neuropathy amongst those who chronically abuse alcohol are, and therefore, it is unknown whether it is attributed to the direct toxic effects of ethanol or another currently unidentified factor. There is presently sparse data to support a particular management strategy in alcohol-related peripheral neuropathy, but the limited data available appears to support the use of vitamin supplementation, particularly of B-vitamin regimens inclusive of thiamine.

Keywords: Alcohol; Alcoholic; Ethanol; Neuropathy; Polyneuropathy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA chart detailing the inclusion/exclusion process
Fig. 2
Fig. 2
Forest plot for the prevalence of peripheral neuropathy amongst chronic alcohol abusers, diagnosed using history and examination alone
Fig. 3
Fig. 3
Forest plot for the prevalence of peripheral neuropathy amongst chronic alcohol abusers, diagnosed using nerve conduction studies with or without supplementary electromyography
Fig. 4
Fig. 4
Forest plot for the prevalence of pain amongst individuals with alcohol-related peripheral neuropathy
See this image and copyright information in PMC

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