Resumen
Introducción: el alcohol etílico es una de las sustancias con mayor consumo a lo largo del mundo. Es un problema de salud pública por su elevada morbilidad y mortalidad, además de su impacto económico.
Contenido: el consumo crónico de alcohol induce cambios en la estructura y función del sistema nervioso central y periférico. Estos efectos neurológicos afectan hasta un 50?% de los consumidores, resultando en múltiples complicaciones neurológicas que pueden llegar a ser irreversibles. Los mecanismos de daño neurológico son variables y dentro de las complicaciones crónicas se encuentran la encefalopatía de Wernicke-Korsakoff, la encefalopatía hepática, la ataxia cerebelosa, la neuropatía alcohólica, la miopatía alcohólica crónica, el síndrome de abstinencia grave y el trastorno del espectro alcohólico fetal.
Conclusiones: el consumo crónico de alcohol puede causar diversas complicaciones neurológicas, el diagnóstico temprano de las mismas y la intervención oportuna del trastorno por consumo de alcohol resulta ser importante y constituye una de las medidas más rentables para evitar complicaciones neurológicas irreversibles secundarias.
Citas
World Health Organization. Global status report on alcohol and health and treatment of substance use disorders. WHO; 2024. https://www.who.int/publications/i/item/9789240096745
Lizasoain Hernández I, Leza JC, Ladero JM, Lorenzo Fernández P. Drogodependencias. 3.ª ed. Panamericana; 2009.
American Psychiatric Association. DSM-5 TM guidebook the essential companion to the Diagnostic and statistical manual of mental disorders, fifth edition. 5.a ed. Washington, D. C.: American Psychiatric Publishing; 2013.
Cohen SM, Alexander RS, Holt SR. The Spectrum of Alcohol Use: Epidemiology, Diagnosis, and Treatment. Med Clin North Am. 2022 Jan;106(1):43-60. https://doi.org/10.1016/j.mcna.2021.08.003
Molina PE, Nelson S. Binge drinking's effects on the body. Alcohol Res. 2018;39(1):99-109.
US Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(18):1899-909. https://doi.org/10.1001/jama.2018.10897
Planas-Ballvé A, Grau-López L, Morillas RM, Planas R. Neurological manifestations of excessive alcohol consumption. Gastroenterol Hepatol. 2017;40(10):709-17. https://doi.org/10.1016/j.gastrohep.2017.05.011
National Institute on Alcohol Abuse, and Alcoholism. Special Report to the US Congress on Alcohol & Health. Department of Health, Education, and Welfare; Alcohol, Drug Abuse, and Mental Health Administration; National Institute on Alcohol Abuse and Alcoholism; 2000.
Nutt D, Hayes A, Fonville L, Zafar R, Palmer EOC, Paterson L, et al. Alcohol and the brain. Nutrients. 2021;13(11):3938. https://doi.org/10.3390/nu13113938
Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Goldfrank's Toxicologic Emergencies, 11.a ed. McGraw-Hill.Education; 2019.
Hammoud N, Jimenez-Shahed J. Chronic neurologic effects of alcohol. Clin Liver Dis. 2019;23(1):141-55. https://doi.org/10.1016/j.cld.2018.09.010
Oudman E, Wijnia JW, Oey MJ, van Dam M, Postma A. Wernicke-Korsakoff syndrome despite no alcohol abuse: a summary of systematic reports. J Neurol Sci. 2021;426:117482. https://doi.org/10.1016/j.jns.2021.117482
Wijnia JW. A clinician's view of Wernicke-Korsakoff syndrome. J Clin Med. 2022;11(22):6755. https://doi.org/10.3390/jcm11226755
Knight-Dunn L, Gorchynski J. Alcohol-related metabolic emergencies. Emerg Med Clin North Am. 2023;41(4):809-19. https://doi.org/10.1016/j.emc.2023.07.003
Rose CF, Amodio P, Bajaj JS, Dhiman RK, Montagnese S, Taylor-Robinson SD, et al. Hepatic encephalopathy: novel insights into classification, pathophysiology and therapy. J Hepatol. 2020;73(6):1526-47. https://doi.org/10.1016/j.jhep.2020.07.013
Elsaid MI, Rustgi VK. Epidemiology of hepatic encephalopathy. Clin Liver Dis. 2020;24(2):157-74. https://doi.org/10.1016/j.cld.2020.01.001
Vannier AGL, Shay JES, Fomin V, Patel SJ, Schaefer E, Goodman RP, et al. Incidence and progression of alcohol-associated liver disease after medical therapy for alcohol use disorder. JAMA Netw Open. 2022;5(5):e2213014. https://doi.org/10.1001/jamanetworkopen.2022.13014
Singal AK, Mathurin P. Diagnosis and treatment of alcohol-associated liver disease: a review. JAMA. 2021;326(2):165-76. https://doi.org/10.1001/jama.2021.7683
Goldman L, Cooney KA. Goldman-Cecil Medicine 2- Volume Set. Elsevier; 2023. Alcoholic and Nonalcoholic Steatohepatitis; p. 1031-1034.e1.
Harris KB, González HC, Gordon SC. The health care burden of hepatic encephalopathy. Clin Liver Dis. 2024;28(2):265-72. https://doi.org/10.1016/j.cld.2024.01.009
Butterworth RF. Hepatic encephalopathy in alcoholic cirrhosis. Handb Clin Neurol. 2014;125:589-602. https://doi.org/10.1016/b978-0-444-62619-6.00034-3
Harper C. The neuropathology of alcohol-related brain damage. Alcohol bran. 2009;44(2):136-40. https://doi.org/10.1093/alcalc/agn102
Mitoma H, Manto M, Shaikh AG. Mechanisms of ethanol-induced cerebellar ataxia: underpinnings of neuronal death in the cerebellum. Int J Environ Res Public Health. 2021;18(16):8678. https://doi.org/10.3390/ijerph18168678
Salazar G, Fragoso M, Español G, Cuadra L. Primary degeneration of the corpus callosum (Marchiafava-Bignami disease): 2 unusual clinical presentations. Neurologia. 2013;28(9):587-9. https://doi.org/10.1016/j.nrl.2012.04.018
Hillbom M, Saloheimo P, Fujioka S, Wszolek ZK, Juvela S, Leone MA. Diagnosis and management of Marchiafava-Bignami disease: a review of CT/MRI confirmed cases. J Neurol Neurosurg Psychiatry. 2014;85(2):168-73. https://doi.org/10.1136/jnnp-2013-305979
Waack A, Nandwani S, Ranabothu M, Ranabothu A, Vattipally V. Marchiafava-Bignami disease: case presentation and radiological imaging. Radiol Case Rep. 2023;18(11):3922-5. https://doi.org/10.1016/j.radcr.2023.08.032
Wirth T, Föckens E, De Cagny H, Lafforgue P, Guis S. Afecciones tóxicas y endocrinas musculares. EMC-Aparato Locomotor. 2022;55(4):1-13. https://doi.org/10.1016/S1286-935X(22)47188-7
Pasnoor M, Barohn RJ, Dimachkie MM. Toxic myopathies. Neurol Clin. 2014;32(3):647-70. https://doi.org/10.1016/j.ncl.2014.04.009
Simon L, Jolley SE, Molina PE. Alcoholic myopathy: pathophysiologic mechanisms and clinical implications. Alcohol Res. 2017;38(2):207-17.
Koike H, Sobue G. Alcoholic neuropathy. Curr Opin Neurol. 2006;19(5):481-6. https://doi.org/10.1097/01.wco.0000245371.89941.eb
Julian T, Glascow N, Syeed R, Zis P. Alcohol-related peripheral neuropathy: a systematic review and meta-analysis. J Neurol. 2019;266(12):2907-19. https://doi.org/10.1007/s00415-018-9123-1
Nath P, Anand AC. Extrahepatic manifestations in alcoholic liver disease. J Clin Exp Hepatol. 2022;12(5):1371-83. https://doi.org/10.1016/j.jceh.2022.02.004
Mirijello A, D’Angelo C, Ferrulli A, Vassallo G, Antonelli M, Caputo F, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-65. https://doi.org/10.1007/s40265-015-0358-1
Sabzali M, Eidi A, Khaksari M, Khastar H. Anti-inflammatory, antioxidant, and antiapoptotic action of metformin attenuates ethanol neurotoxicity in the animal model of fetal alcohol spectrum disorders. Neurotox Res 2022. 40(2):605-13. https://doi.org/10.1007/s12640-022-00499-2
Popova S, Charness ME, Burd L, Crawford A, Hoyme HE, Mukherjee RAS, et al. Fetal alcohol spectrum disorders. Nat Rev Dis Primers. 2023;9(1):11. https://doi.org/10.1038/s41572-023-00420-x

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