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Alcoholic Myelopathy and Nutritional Deficiency
Haruki Koike1, Tomohiko Nakamura, Shohei Ikeda
1Department of Neurology, Nagoya University Graduate School of Medicine, Japan.
Internal Medicine (Tokyo, Japan)
|January 5, 2017
Summary
Chronic alcoholism can cause myelopathy due to low folate and cobalamin levels. Supplementation and abstinence halted neurological decline in one patient, highlighting the need for nutritional monitoring.
Area of Science:
- Neurology
- Nutritional Science
Background:
- Chronic alcoholism is a significant risk factor for various neurological complications.
- Nutritional deficiencies, particularly of folate and cobalamin (vitamin B12), are common in alcohol-dependent individuals.
Observation:
- A 42-year-old male with chronic alcoholism presented with a 4-month history of gait disturbance.
- Neurological examination revealed significant spasticity, hyperreflexia, and extensor plantar responses in the lower limbs.
- Laboratory tests showed decreased cobalamin and markedly low serum folate levels, with normal plasma ammonia.
Findings:
- The patient's myelopathy and neurological deficits were directly linked to severe folate and cobalamin deficiencies.
- Treatment with folic acid and cobalamin supplementation, alongside alcohol abstinence, effectively halted the progression of neurological symptoms.
Implications:
- This case underscores the critical importance of monitoring nutritional status, specifically folate and cobalamin, in alcoholic patients presenting with myelopathy.
- Early detection and intervention for nutritional deficiencies can prevent or mitigate severe neurological damage in this population.
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