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Alcohol and the central nervous system
  1. Maytal Wolfe1,2,
  2. Arun Menon1,3,
  3. Maria Oto2,
  4. Natasha E Fullerton1,2,
  5. John-Paul Leach2
  1. 1University of Glasgow, Glasgow, UK
  2. 2Queen Elizabeth University Hospital, Glasgow, UK
  3. 3Gartnavel Royal Hospital, Glasgow, UK
  1. Correspondence to Professor John-Paul Leach, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK; jpleach246{at}


Ethanol use is common to most cultures but with varying doses and to varying extents. While research has focused on the effects on the liver, alcohol exerts a range of actions on the function and structure of the nervous system. In the central nervous system (CNS) it can provoke or exacerbate neurological and psychiatric disease; its effects on the peripheral nervous system are not included in this review. Sustained alcohol intake can predispose to acute neurochemical changes which, with continued ingestion and incomplete treatment, can lead to chronic structural changes in the CNS: these include generalised cortical and cerebellar atrophy, amnesic syndromes such as Korsakoff’s syndrome, and specific white matter disorders such as central pontine myelinolysis and Marchiafava–Bignami syndrome. Alcohol in pregnancy commonly and significantly affects fetal health, though this receives less medical and political attention than other causes of fetal harm. This review looks at the range of disorders that can follow acute or chronic alcohol use, and how these should be managed, and we provide a practical overview on how neurologists might diagnose and manage alcohol addiction.


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  • Twitter @drarunmenon, @jpleach246

  • Collaborators Not applicable.

  • Contributors J-PL and MW wrote first draft. MW provided composite case histories MO and AM helped edit subsequent drafts NEF sourced imaging and provided expert commentary.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned. Externally peer reviewed by Joanna Lovett, Southampton, UK and Martin Sadler, Plymouth, UK.

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