Alcohol and CMT

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This is a repost: for anyone new, this can be found in our " Files " area

- you may want to print and make copies. This is from one of the old

newsletters. ~ G

Alcohol and CMT

Doctors reiterate that alcohol is the worst thing we can take into our

bodies on a regular basis. From shaky knees, numbness, tremors,

confusion and almost instant DTs, the consumption of alcohol has made it

abundantly clear to some people with CMT that they should not drink.

Some people with CMT can drink, in moderation, with no problems but you

should be aware that it is not the best thing to do for your CMT.

The Damaging Effect of Alcohol in Charcot-Marie-Tooth Disease by Dr.

Victor Ionasescu (April 1989)

The close association of alcoholism and peripheral nerve disease has

been appreciated for many years . In a study of 1030 alcoholics admitted

to Boston City Hospital, 92 (9%) proved to have peripheral nerve disease

(Victor, M and , RD: The Effect of Alcohol on the Nervous System.

Res Publ Assoc Res Nerve Dis 1953, 32:526).

In the background of patients with alcoholic neuropathy, two features

are invariably present: the abuse of alcohol, usually severe in degree

and of many years' duration, and dietary deficiency. The diets of these

patients were conspicuously low in meat and fish, cereals and fresh

fruits and vegetables.

The essential pathologic alteration in alcoholic neuropathy is a

degeneration of the peripheral nerves. Both myelin and axons are

destroyed, the latter probably earlier and to a greater extent than the

former. More recent studies definitely indicated that segmental

demyelination is a rare finding in alcoholic neuropathy and axonal

degeneration is the basic histologic abnormality. The clinical picture

varies considerably. In its mildest form, the neuropathy is virtually

asymptomatic, the presence of peripheral nerve disease being disclosed

only on neurologic examination.

The neuropathic signs in these asymptomatic cases consist of thinness

and tenderness of the leg muscles, loss of depression of some reflexes

and an inconstant impairment in the perception of painful and tactile

stimuli over the feet and shins. If alcoholic patients are examined

electrophysiologically, a certain proportion will show impairment of

peripheral nerve function before the clinical signs of neuropathy can be

detected. The majority of alcoholic patients with involvement of the

peripheral nerves have symptoms - weakness, tingling, numbness, and pain

of the feet and hands. These symptoms are usually insidious in onset and

slowly progressive.

Charcot-Marie-Tooth (CMT) neuropathy is characterized by weakness of the

feet and hands, foot deformities, including permanently flexed " hammer "

toes, and unusually high arches and some loss of sensation in the limbs.

The disease is inherited in different ways: autosomal dominant,

autosomal recessive or X-linked. The motor symptoms (weakness) and the

pathology (nerve degeneration) resemble very much the alcoholic

neuropathy. The main distinctions are: a) presence of foot deformities,

absence of mildness of sensory symptoms such as tingling, numbness

and pain of the feet and hands.

Recently, we became aware that some of our CMT patients have an

excessive daily intake of alcohol (more than three glasses of wine per

day). We compared the neurologic signs in the few alcoholic and the

large group of non-alcoholic CMT patients. The numbers of alcoholic CMT

patients is small and does not allow statistical analysis. However, it

is obvious that the alcoholic CMT patients have more severe weakness

and/or sensory symptoms than the non-alcoholic CMT patients. Close

questioning of two alcoholic CMT patients disclosed that there was a

sudden worsening of symptoms after alcohol daily intake on a background

of chronic and relatively mild neuropathy. These findings should not

surprise us. The abuse of alcohol is more damaging for CMT nerves which

already show a degeneration secondary to the undetermined genetic

defect.

In conclusion, alcoholic drinks should be forsaken entirely or strictly

limited if you have CMT.