Jornal de Toxicologia Clínica
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Clinical Analysis in Chronic Alcoholic Encephalopathy: A Retrospective Study of 43 Subjects

Honghong Li, Lei He, Shuwei Qiu, Yi Li and Ying Peng

Background and purpose: Chronic alcoholic encephalopathy (CAE) refers to the effects of chronic alcohol consumption on cerebral structure and function in human. The diagnosis is frequently missed for its atypical clinical presentation. Here, we performed this retrospective study to analyze clinical manifestations, neuroimaging findings and electroencephalography (EEG) alterations in CAE patients, with the aim to highlight the importance of recognition or diagnosis of CAE.

Patients and methods: We analyzed the clinical manifestations, neuroimaging findings and EEG alterations of 43 patients (42 males and 1 female) with CAE diagnosed in Sun-Yat Sen Memory Hospital, Guangzhou from 1998 to 2013.

Results: Mental impairment (25.58%), limbs tremor (25.58%), and dizziness (25.58%) were the most frequent clinical manifestations. Other less common presentations including memory impairment (16.28%), ataxia (13.95%), dysarthria (13.95%), consciousness disturbance (11.63%), epileptic seizure (11.63%), ocular motor dysfunction (0.11%), dementia (0.11%), and headache (0.05%) were also observed. Neuroimaging findings showed brain atrophy, ischemia, and demyelinated changes. Among 14 patients who undertwent EEG examination, diffuse slow wave or theta rhythm (3-4 Hz, 10-40 uV) was found in 10 patients. Most patients with CAE showed good response to abstinence and vitamin B supplement.

Conclusion: For the alcoholic patients, detailed medical history and close follow-up with MRI scan and EEG are valuable tools to detect CAE. Abstinence combined with vitamin B supplement usually obtain a gratifying clinical improvement.