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Alcohol Neuropathy — RACP Adult Medicine MCQ

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EasyNeurologyAlcohol NeuropathyRACP Adult Medicine

A 60-year-old man with a 30-year history of heavy alcohol consumption presents with painful burning feet, distal muscle wasting in the legs, and gait instability. He also has macrocytosis and elevated GGT. Nerve conduction studies show axonal sensorimotor polyneuropathy. B12 and folate are normal. What is the most likely diagnosis?

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Correct answer: A — Alcohol-related neuropathy

Axonal sensorimotor polyneuropathy with painful burning feet in a chronic heavy drinker with macrocytosis and elevated GGT is alcohol-related neuropathy. It results from direct neurotoxicity and nutritional deficiency (thiamine). Management includes alcohol cessation, thiamine supplementation, and neuropathic pain management.

Reference: eTG Neurology – 2024 – Alcohol-Related Neuropathy