Signs and Symptoms
Alcoholic polyneuropathy usually has a gradual onset over months or even years although axonal degeneration often begins before an individual experiences any symptoms. An early warning sign (prodrome) of the possibility of developing alcoholic polyneuropathy, specially in a chronic alcoholic, would be weight loss because this usually signifies a nutritional deficiency that can lead to the development of the disease.
The disease typically involves sensory and motor loss, as well as painful physical perceptions (paresthesias), though all sensory modalities may be involved. The symptoms affecting the sensory and motor systems seem to develop in a symmetrical pattern; for example, if the right foot is affected, the left foot will be affected simultaneously or soon thereafter as well. In most cases the legs are affected first, followed by the arms. The hands usually become involved when the symptoms reach above the ankle level. This is called a stocking-and-glove pattern of sensory disturbances.
The polyneuropathy that develops spans a large range of severity. Some cases are seemingly asymptomatic and may only be recognized upon careful examination. The most severe cases may result in profound physical disability.
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