How Does Alcohol Impact Neurological Health?
Chronic heavy drinkers may be at risk for several different alcohol-related neurological issues. Alcohol use can have a serious impact on the brain and the entire nervous system and influence the development of different alcoholic neurological disorders.1 If you or a loved one are struggling with the adverse neurological effects of alcohol, or you’re concerned about how your alcohol use might impact brain health, you may benefit from learning more about these issues and how to find help for alcohol addiction.
Neurological Effects of Alcohol & Risks
Alcohol can have a wide range of effects on your brain—impacting its overall functioning, disrupting communication pathways, and, over time, contributing to the development of many neurological disorders.2
For example, alcohol can impact and have toxic effects on brain circuits and, with chronic misuse, damage areas of the brain that impact memory, decision-making, impulse control, attention, sleep regulation, and other cognitive functions.2 People can also develop alcohol use disorder (AUD), a diagnostic term for alcohol addiction, which can arise in association with certain types of brain changes that occur due to chronic alcohol use.2
Some of the more common alcohol-related neurologic disorders can include:
- Alcoholic neuropathy.
- Alcoholic cerebellar degeneration.
- Alcoholic myopathy.
- Wernicke-Korsakoff syndrome.
- Alcohol-related stroke.
The term neuropathy refers to conditions that arise as a result of neurological injury or damage and the disrupted nerve signaling that results from such changes. Neuropathies may be caused several different health issues, including excessive alcohol use.3 Alcoholic neuropathy is one of the most common neurological complications of chronic alcohol use.4 Alcohol related neuropathies can develop specifically due to alcohol’s directly toxic effects on neurons as well as in association with acquired nutritional deficiencies related to chronic alcohol use.3, 4
Estimates indicate that up to 66% of people who have chronic AUD experience some form of alcoholic neuropathy.1 The condition tends to affect the lower legs, with symptoms such as:4
- Paresthesias (burning or prickling sensations that feel like pins and needles).
- Ataxia (poor muscle control).
Treatment of this condition centers around stopping continued drinking. With abstinence for several months to years, complete remission of the condition and a full regain of function is possible.1
Alcohol Cerebellar Degeneration
Alcohol cerebellar degeneration is a prevalent neurological condition among people with alcohol use disorders, and one of the most common cause of cerebellar-related problems with movement and coordination.5 The cerebellum is a part of your brain important for controlling balance so you can walk and stand and perform other complex functions.6
Though the precise mechanisms aren’t well understood, continued alcohol misuse can lead to cerebellar atrophy and other degenerative changes that result in significant functional impairment.5 Researchers believe it may involve a combination of excitotoxicity (meaning harmful effects caused by excessive activation of amino acid receptors), dietary factors like thiamine deficiency, oxidative stress, compromised energy production, and cell death.5, 7
People who chronically misuse alcohol can develop this condition over a period of weeks or months, but it can also occur suddenly.8 One study indicates that consuming 150 g of alcohol (for reference, one standard drink contains about 14 grams of alcohol) every day for 10 years resulted in significant cerebellar atrophy in 30% of participants.8, 9
Common symptoms of alcohol cerebellar degeneration include:8
- Problems with walking.
- Unstable posture.
- Lower limb ataxia.
- Upper limb ataxia (in advanced cases).
- Dysarthria (problems speaking due to muscle weakness).
- Leg tremors.
Though the neurological deficits of alcohol related cerebellar degeneration may be chronic or persistent for some people, alcohol use disorder treatment and abstinence maintenance, along with adequate nutrition and, in some cases, physical and neuropsychological rehabilitation may help to stabilize progression of the condition.8
Myopathy is a broad term that refers to any of several pathological conditions that affect skeletal muscle structure and function, with such conditions often resulting in muscle weakness and pain.10 There are many types of myopathies, including those that are genetic in origin, but alcoholic myopathy is thought to develop secondary to a several potentially toxic influences of alcohol on muscle tissue.10, 11 It can be an acute or chronic condition, with acute alcoholic myopathy affecting around 20 people per 100,000 with AUD in western countries, and the far more common chronic alcoholic myopathy affecting 2,000 per 100,000 people.11
Alcoholic myopathy can be caused by a number of factors related to alcohol’s damaging effects on muscle tissue, including nutritional deficiencies, reduced protein synthesis, oxidative stress, disturbances in nerve signaling due to mitochondrial dysfunction, and inflammation.11
Acute alcoholic myopathy results in the breakdown of muscle fibers and can occur after just one binge drinking episode (4-5 drinks in a single sitting). It generally resolves after a week or two.11 Chronic alcoholic myopathy is a progressive condition that can develop over the course of weeks to months.11
Common symptoms of alcoholic myopathy include:
- Muscle weakness.10
- Difficulty standing up from a seated position, climbing stairs, or doing overhead activities.10
- Muscle atrophy.11
- Muscle twitching.11
- Myotonia, or muscle tightness.11
Management of alcohol-related myopathies begins with complete alcohol abstinence. Some cases of acute alcoholic myopathy may entirely resolve within days to weeks of abstinence. For more chronic issues, a majority of people experience significant functional improvements within the first year of quitting drinking, with complete return of affected muscle strength by the fifth year. 11
Wernicke-Korsakoff syndrome is a neurological condition that can be caused by thiamine deficiency, which can sometimes occur in association with chronic alcohol abuse.12 The syndrome contains a combination of progressive symptom stages known as Wernicke’s encephalopathy and Korsakoff’s syndrome.12 Wernicke’s encephalopathy reflects the more acute presentation of symptoms, and is characterized by confusion, vision problems, coma, hypothermia, low blood pressure, and lack of muscle coordination.12 The condition may then progress to include more chronic and persistent issues denoted as Korsakoff’s syndrome, which includes symptoms such as amnesia, disorientation, tremor, and vision problems.12
The main concern with Wernicke-Korsakoff syndrome is that people are unable to acquire new information or establish new memories, and they are unable to access prior memories.12 Many of the symptoms are reversible if people receive prompt treatment with thiamine replacement followed by improved nutrition and hydration replenishment, however in some case, memory improvement may be relatively slow and incomplete.12 Quitting drinking will help prevent additional progressive neurological deterioration.
Alcohol and Stroke Risk
There is also evidence that suggests that alcohol consumption may contribute to the risk of strokes. The amount of alcohol can play a role, as one major study indicates that high and moderate alcohol intake (moderate was defined as 7–14 drinks per week for women and 7–21 for men, and high was more than 14 drinks for women and more than 21 for men) was associated with increased odds of stroke, whereas low intake (1–7 drinks per week) was not associated with stroke.13
The reasons why alcohol increases stroke risk aren’t entirely clear and may involve a complex interaction of factors. Some hypothesize that the increased risk of stroke could be due to alcohol’s effects on blood pressure, alterations in cholesterol, reductions in fibrinogen (which plays a role in blood clotting), altered endothelial function, inflammation, and provocation of atrial fibrillation or other cardiac arrhythmias.13
Alcohol Addiction Treatment
If you or a loved one are struggling with alcohol misuse or addiction, you should know that there are many treatment options available to help you start the path to recovery. Effective treatment should be customized based on your unique needs and take into account any medical (including neurological) problems, psychological concerns, and social difficulties you may be dealing with.14
Treatment might start with detox to help you through the withdrawal period, followed by inpatient or outpatient rehab to help you work on the underlying issues associated with alcohol misuse.14 Treatment often involves a combination of medications, behavioral therapies, counseling, and participation in mutual support groups, like Alcoholics Anonymous (AA).14
The first step in seeking help for alcohol addiction might be to consult your healthcare provider. They can perform an evaluation, help determine the appropriate setting based on your unique needs, and provide referrals to rehabs. You can also find treatment facilities nationwide using the Substance Abuse and Mental Health Services Administration’s FindTreatment.gov website.
Addiction helplines, like the one operated by American Addiction Centers, can also be powerful resources for those seeking help of alcohol addiction. Our compassionate staff is available 24/7 and may be able to help answer your questions about alcohol addiction and related health issues, help you locate suitable rehab centers, and help you to verify your insurance coverage. Don’t delay, reach out to us today at .
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