Beyond the Liver: Neurologic Manifestations of Alcohol Use.

Tian Wang, Chencheng Xie, Jiannan Huang, Ibrahim Munaf Ahmed

Journal: Clinics in liver disease 2024;28(4):681-697

PMID: 39362715

Full Text on Elsevier Science View on PubMed

Abstract

Alcohol use, while commonly associated with liver damage, also has significant neurologic implications, which often mimic hepatic encephalopathy and complicate diagnosis and management. Alcohol mediates its acute central nervous system effects by altering neurotransmitter balance, notably between gamma-aminobutyric acid and glutamate. Its chronic neurotoxicity, compounded by thiamine deficiency, results in chronic neurologic complications. Clinically, alcohol-related neurologic disorders present a spectrum from acute intoxication and withdrawal to chronic conditions like Korsakoff syndrome, dementia, cerebellar degeneration, and peripheral neuropathy. This review underscores differentiating these conditions from hepatic encephalopathy and highlights the importance of history-taking and physical examination in clinical practice.

Address: Department of Internal Medicine, University of South Dakota Sanford School of Medicine, 1400 West 22nd Street, Sioux Falls, SD 57105, USA.; Department of Neurology, Georgetown University, Washington, DC, USA; Georgetown University Medical Center, Comprehensive Epilepsy Center, MedStar Georgetown University Hospital, MedStar Southern Maryland Hospital Center, 10401 Hospital Drive, Suite 102, Clinton, MD 20735, USA.; Department of Internal Medicine, University of South Dakota Sanford School of Medicine, 1400 West 22nd Street, Sioux Falls, SD 57105, USA; Division of Hepatology, Avera McKennan Hospital & University Health Center, 1315 South Cliff Avenue, Suite 1200 Plaza 3, Sioux Falls, SD 57105, USA. Electronic address: [email protected].

DOI: 10.1016/j.cld.2024.06.004

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MeSH Terms: Humans, Hepatic Encephalopathy, Alcoholism, Diagnosis, Differential, Peripheral Nervous System Diseases, Alcohol Drinking, Dementia, Korsakoff Syndrome, Alcoholic Korsakoff Syndrome, Alcoholic Neuropathy