Skip to main content

The Effects of Alcohol on the Nervous System

Clinical Features, Pathogenesis, and Treatment

  • Chapter

Abstract

Virtually every organ system is affected adversely by the excessive ingestion of alcohol,* but none more frequently or more seriously than the nervous system. Unlike the effects of alcohol on nonneural organs and structures, the clinical effects on the nervous system are remarkably diverse. This diversity derives from the fact that alcohol or alcoholism induces its clinical effects by several different mechanisms, namely, by a direct toxic effect on nerve cells, by the withdrawal of alcohol after a period of chronic intoxication, by inducing a state of nutritional deficiency that may affect the central or peripheral nervous system or both, and by crossing the placenta and damaging the fetal brain. The varied mechanisms by which alcohol affects the nervous system serve as the basis for the classification shown in Table 14.1.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Adams, R. D., and Foley, J. M.: The neurological disorder associated with liver disease. Res. Publ. Assoc. Res. Nerv. Ment. Dis. 32:198, 1953.

    Google Scholar 

  • Adams, R. D., Victor, M., and Mancall, E. L.: Central pontine myelinolysis. Arch. Neurol. Psychiatry 81:154, 1959.

    Google Scholar 

  • Alldredge, B. K., and Simon, R. P.: Treatment of alcohol withdrawal seizures with phenytoin. In: Alcohol and Seizures. (R. J. Porter, R. H. Mattson, J. A. Cramer, and I. Diamond, eds.), Philadelphia, F A. Davis, 1990, pp. 290–297.

    Google Scholar 

  • Artmann, H., Gall, M. V., Hacker, H., and Herrlich, J.: Reversible enlargement of cerebral spinal fluid space in chronic alcoholics. Am. J. Neuroradiol. 2:23–27, 1981.

    Google Scholar 

  • Banay, R. S.: Pathologic reaction to alcohol: 1. Review of the literature and original case reports. Q. J. Stud. Alcohol 4:580, 1944.

    Google Scholar 

  • Baughman, F. A., Jr., and Papp, J. P.: Wernicke’s encephalopathy with intravenous hyperalimentation: Remarks on similarities between Wernicke’s encephalopathy and the phosphate depletion syndrome. Mt. Sinai J. Med. N.Y. 43:48–52, 1976.

    Google Scholar 

  • Behse, E, and Buchthal, F.: Alcoholic neuropathy: Clinical, electrophysiological and biopsy findings. Ann. Neurol. 2:95, 1977.

    Google Scholar 

  • Bentson, J., Reza, M., Winter, J., and Wilson, G.: Steroids and apparent cerebral atrophy on computed tomography scans. J. Comput. Assist. Tomogr. 2:16–23, 1978.

    Google Scholar 

  • Birchfield, R. I.: Postural hypotension in Wernicke’s disease: A manifestation of autonomic nervous system involvement. Am. J. Med. 36:404, 1984.

    Google Scholar 

  • Bischoff, A.: Die alkoholische Polyneuropathie. Dtsch. Med. Wochenschr. 96:317–322, 1971.

    Google Scholar 

  • Blackstock, E., Ruschworth, G., and Gath, D.: Electrophysiological studies in alcoholism. J. Neurol. Neurosurg. Psychiatry 35:326–334, 1972.

    Google Scholar 

  • Blass, J. P., and Gibson, G. E.: Abnormality of a thiamine-requiring enzyme in patients with Wernicke-Korsakoff syndrome. N. Engl. J. Med. 297:1367–1370, 1977.

    Google Scholar 

  • Bleuler, E.: Textbook of Psychiatry (trans. A. A. Brill), New York, Macmillan, 1951, p. 327.

    Google Scholar 

  • Bomb, B. S., Bedi, H. K., and Bhatnagar, K.: Post-ischemic paresthesia in pellagrins. J. Neurol. Neurosurg. Psychiatry 40:265–267, 1977.

    Google Scholar 

  • Bonhoeffer, K.: Die akuten Geisteskrankheiten der Gewohnheitstrinker. Eine klinische Studie VIII, Jena, Fisher, 1901, p. 226.

    Google Scholar 

  • Bostock, J.: Alcoholism and its treatment. Med. J. Aust. 26:136, 1939.

    Google Scholar 

  • Bowman, K. M., and Jellinek, E. M.: Alcoholic mental disorders. Q..1: Stud. Alcohol 2:312, 1941.

    Google Scholar 

  • Bowman, K. M., Wortis, H., and Keiser, S.: The treatment of delirium tremens. J.A.M.A. 112:1217, 1939.

    Google Scholar 

  • Bratz, D.: Alkohol und Epilepsie. Allg. Z. Psychiatrie 56:334, 1899.

    Google Scholar 

  • Brewer, C., and Perrett, L.: Brain damage due to alcohol consumption: An air-encephalographic, psychometric and electroencephalographic study. Br. J. Addict. 66:170–182, 1971.

    Google Scholar 

  • Brunner, J. E., Redmond, J. M., Haggar, A. M., Kruger, D. F., and Elias, S. B.: Central pontine myelinolysis and pontine lesions after rapid correction of hyponatremia: A prospective magnetic resonance imaging study. Ann. Neurol. 27:61–66, 1990.

    Google Scholar 

  • Bumke, O., and Kant, E: Trunksucht und chronisher Alkoholismus. In: Handbuck der Neurologie, Vol. 13 (O. Bumke and O. Foerster, eds.), Berlin, Springer, 1936, p. 828.

    Google Scholar 

  • Burcar, P. J., Notenberg, M. D., and Yarnell, P. R.: Hyponatremia and central pontine myelinolysis. Neurology (Minneap.) 27: 223–226, 1977.

    Google Scholar 

  • Butler, D., and Messiha, F. S.: Alcohol and withdrawal and carbamazepine. Alcohol 3:113–129, 1986.

    Google Scholar 

  • Carlen, P. L., and Wilkinson, D. A.: Alcoholic brain damage and reversible deficits. Acta Psychiatr. Scand. [Suppl.] 286:89–101, 1980.

    Google Scholar 

  • Carlen, P. L., Wortzman, G., Holgate, R. C., Wilkinson, D. A., and Rankin, J. C.: Reversible cerebral atrophy in recently abstinent chronic alcoholics measured by computed tomography scans. Science 200:1076–1078, 1978.

    Google Scholar 

  • Carlsson, C., and Haggendal, J.: Arterial noradrenaline levels after ethanol withdrawal. Lancet 2:889, 1967.

    Google Scholar 

  • Chafetz, M. E.: Alcoholism and alcoholic psychoses. In: Comprehensive Textbook of Psychiatry, 2nd ed. (A. M. Freeman, H. I. Kaplan, and J. B. Sadock, eds.), Baltimore, Williams & Wilkins, 1975, p. 343.

    Google Scholar 

  • Charness, M. E.: Molecular mechanisms of ethanol intoxication, tolerance, and physical dependence. Chap. 5. In: Medical Diagnosis and Treatment of Alcoholism (Mendelson, J. H., and Mello,. N. K., eds.), New York, McGraw-Hill, 1992, pp. 155–199.

    Google Scholar 

  • Cooper, A. J. L., and Plum, F: Biochemistry and physiology of brain ammonia. Physiol. Rev. 67:440–519, 1987.

    Google Scholar 

  • Courville, C. B.: Effects of Alcohol on the Nervous System of Man. Los Angeles, San Lucas, 1955.

    Google Scholar 

  • Cruickshank, E. K.: Wernicke’s encephalopathy. Q. J. Med. 19:327, 1950.

    Google Scholar 

  • Cushman, P. Jr., Forbes, R., Lerner, W, and Stewart, M.: Alcohol withdrawal syndromes: Clinical management with lofexidine. Alcoholism 9:103–108, 1985.

    Google Scholar 

  • Cutting, J.: The relationship between Korsakoffs syndrome and “alcoholic dementia.” Br. J. Psychiatry 132:240, 1978.

    Google Scholar 

  • Czaja, C., and Kalant, H.: The effect of acute alcoholic intoxication on adrenal ascorbic acid cholesterol in the rat. Can. J. Biochem. Physiol. 39:327, 1961.

    Google Scholar 

  • Delay, J., Boudin, G., Brion, S., and Barbizet, J.: Étude anatamoclinique de huit encephalopathies alcooliques: Encepha-lopathie de Wernicke et syndromes voisins. Encephale 47:99, 1958.

    Google Scholar 

  • Delay, J., Brion, S., Escourelle, R., and Sanchez, A.: Rapports entre la dégénérescence du corpos calleux de Marchiafava Bignami et la sclerose laminaire corticale de Morel. Encephale 49:281, 1959.

    Google Scholar 

  • Denny-Brown, D. E.: The neurological aspects of thiamine deficiency. Fed. Proc. 17(Suppl. 2):35, 1958.

    Google Scholar 

  • Denvenyi, P, and Harrison, M. J.: Prevention of alcohol withdrawal seizures with oral diazepam loading. Can. Med. Assoc. J. 135:798–800, 1985.

    Google Scholar 

  • de Wardener, H. E., and Lennox, B.: Cerebral beriberi (Wernicke’s encephalopathy). Lancet 1:11, 1947.

    Google Scholar 

  • Dodge, R., and Benedict, F. G.: Psychological Effects of Alcohol (Publication 232), Washington, D.C., Carnegie Institution of Washington, 1915.

    Google Scholar 

  • Donnai, J. E, Heinz, E. R., and Burger, P. C.: MR of reversible thalamic lesions in Wernicke syndrome. Am. J. Neuroradiol. 11:893–894, 1990.

    Google Scholar 

  • Drenick, E. J., Joven, C. B., and Swenseid, M. E.: Occurrence of acute Wernicke’s encephalopathy during prolonged starvation for the treatment of obesity. N. Engl. J. Med. 274:937–939, 1966.

    Google Scholar 

  • Dreyfus, P. M.: Clinical application of blood transketolase determinations. N. Engl. J. Med. 267:596, 1962.

    Google Scholar 

  • Dreyfus, P. M., and Victor, M.: Effects of thiamine deficiency on the central nervous system. Am. J. Clin. Nutr. 9:414, 1961.

    Google Scholar 

  • Dublin, A. B., and Dublin, W. A.: Cerebral pseudoatrophy and computed tomography: Two illustrative case reports. Surg. Neurol. 10:209, 1978.

    Google Scholar 

  • Duncan, G., Johnson, R. H., Lambie, D. G., and Whiteside, E. A.: Evidence of vagal neuropathy in chronic alcoholics. Lancet 2:1053–1057, 1980.

    Google Scholar 

  • Ellis, F. W., and Pick, J. R.: Ethanol-induced withdrawal reactions in rhesus monkeys. Pharmacologist 11:256, 1969.

    Google Scholar 

  • Endo, Y., and Oda, M.: Central pontine myelinolysis. Acta Neuro-pathol. 53:145–153, 1981.

    Google Scholar 

  • Enzmann, D. R., and Lane, B.: Cranial computed tomography findings in anorexia nervosa. J. Comput. Assist. Tomogr. 1: 410–414, 1977.

    Google Scholar 

  • Epstein, P. S., Pisani, V. D., and Fawcett, J. A.: Alcoholism and cerebral atrophy. Clin. Exp. Res. 1:61–65, 1977.

    Google Scholar 

  • Escobar, A., Aruffo, C., and Rodriguez-Carbajal, J.: Wernicke’s encephalopathy. A case report with neurophysiologic and CT scan studies. Acta Vitaminol. Enzymol. 5:125–131, 1983.

    Google Scholar 

  • Essig, C. F., and Lam, R. C.: Convulsions and hallucinatory behavior following alcohol withdrawal in the dog. Arch. Neurol. 18:626–632, 1968.

    Google Scholar 

  • Fere, E.: L’Epilepsie. Paris, Gauthier-Willars et Fils, 1896, p. 227.

    Google Scholar 

  • Field, J. B., Williams, H. E., and Mortimore, G. E.: Studies on the mechanism of ethanol-induced hypoglycemia. J. Clin. Invest. 42:497, 1963.

    Google Scholar 

  • Flink, E. B.: Magnesium deficiency in alcoholism. Alcoholism: Clin. Exp. Res. 10:590–594, 1986.

    Google Scholar 

  • Forno, L. S., and Rivera, L.: Central pontine myelinolysis. J. Neuropathol. Exp. Neurol. 34:77, 1975.

    Google Scholar 

  • Freinkel, N., Singer, D. L., Arky, R. A., Bleicher, S. J., Anderson, J. B., and Silbert, C. K.: Alcohol hypoglycemia: I. Carbohy-drate metabolism of patients with clinical alcohol hypoglycemia and the experimental reproduction of the syndrome with pure ethanol. J. Clin. Invest. 42:1112, 1963.

    Google Scholar 

  • French, S. W., and Morris, J. R.: Ethanol dependence in the rat induced by nonintoxicating levels of ethanol. Res. Commun. Chem. Pharmacol. 4:221–233, 1972.

    Google Scholar 

  • Freund, G.: Alcohol withdrawal syndrome in mice. Arch. Neurol. 21:315–320, 1969.

    Google Scholar 

  • Frezza, M., DiPadova, C., Pozzato, G., Terpin, M., Baraona, E., and Lieber, C.S.: High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. N. Engl. J. Med. 322:95–99, 1990.

    Google Scholar 

  • Gabuzda, G. J., Phillips, G. B., and Davidson, C. S.: Reversible toxic manifestations in patients with cirrhosis of the liver given cation exchange resins. N. Engl. J. Med. 246:124, 1952.

    Google Scholar 

  • Gallucci, M., Bozzao, A., Splendiani, A., Masciocchic, C., and Passariello, R.: Wernicke encephalopathy: MR findings in five patients. Am. J. Neuroradiol. 11:887–892, 1990.

    Google Scholar 

  • Garde, A., Girard, P. F., and Pallasse, A.: L’encephalopathie hemorrhagique de Gayet-Wernicke et la degenerescence subaique du corps calleux (Marchiafava-Bignami): A propos d’une observation anatomoclinique. Rev. Lyon Med. 1:99, 1952.

    Google Scholar 

  • Gessner, P. K.: Drug therapy of the alcohol withdrawal syndrome. In: Biochemistry and Pharmacology of Ethanol, Vol. II, (E. Majehrowicz and E. P. Noble, eds.), New York, Plenum, 1979, pp. 375–435.

    Google Scholar 

  • Ghez, C.: Vestibular paresis: A clinical feature of Wernicke’s disease. J. Neurol. Neurosurg. Psychiatry 32:134–139, 1969.

    Google Scholar 

  • Girard, P. F., Garde, A., and Devic, M.: Considérations terminologiques, étiologiques, anatomiques et cliniques concernant l’encephalopathie de Gayet-Wernicke: Ses rapports avec le syndrome de Marchiafava-Bignami et la psychose de Korsakow. Rev. Neurol. 88:236, 1953.

    Google Scholar 

  • Goldsmith, G. A., Sarrett, H. P, Register, U. D., and Gibbens, J.: Studies of niacin requirement in man: Experimental pellagra in subjects on corn diets low in niacin and tryptophan. J. Clin. Invest. 31:533, 1952.

    Google Scholar 

  • Goldstein, D. B.: Relationship of alcohol dose to intensity of withdrawal signs in mice. J. Pharmacol. Exp. Ther. 180:203–215, 1972.

    Google Scholar 

  • Goldstein, D. B.: Pharmacology of Alcohol. New York, Oxford University Press, 1983.

    Google Scholar 

  • Goodwin, D. W, Othmer, E., Halikas, J. A., and Freemon, F.: Loss of short-term memory as a predictor of the alcoholic “blackout.” Nature 227:201–202, 1970.

    Google Scholar 

  • Graham, J. R., Woodhouse, D., and Read, F. H.: Massive thiamine dosage in an alcoholic with cerebellar cortical degeneration. Lancet 2:107, 1971.

    Google Scholar 

  • Gravallese, M. A., and Victor, M.: Circulatory studies in Wernicke’s encephalopathy. Circulation 15:836, 1957.

    Google Scholar 

  • Greenblatt, M., Levin, S., and DeCorli, F.: The electroencephalogram associated with chronic alcoholism, alcoholic psychosis, and alcoholic convulsions. Arch. Neurol. Psychiatry 52:290, 1944.

    Google Scholar 

  • Greenfield, J. G.: Neuropathology (J. G. Greenfield, ed.), London, Edward Arnold, 1958, p. 26.

    Google Scholar 

  • Griffiths, P. J., Littleton, J. M., and Ortiz, A.: A method for the induction of dependence to ethanol in mice. Br. J. Pharmacol. 47:669–670, 1973.

    Google Scholar 

  • Halstead, C. H., Robles, E. A., and Mezey, E.: Decreased jejuna] uptake of labeled folic acid (3H-PGA) in alcoholic patients: Roles of alcohol and nutrition. N. Engl. J. Med. 285:701, 1971.

    Google Scholar 

  • Halstead, C. H., Robles, E. A., and Mezey, E.: Intestinal malabsorption in folate-deficient alcoholics. Gastroenterology 64: 526, 1973.

    Google Scholar 

  • Hare, F: Alcohol and delirium tremens. Br. Med. J. 1:446, 1915.

    Google Scholar 

  • Harper, C. G.: The incidence of Wernicke’s encephalopathy in Australia—a neuropathological study of 131 cases. J. Neurol. Neurosurg. Psychiatry 46:593, 1983.

    Google Scholar 

  • Haug, J. O.: Pneumoencephalographic evidence of brain damage in chronic alcoholics: A preliminary report. Acta Psychiatry. Scand. [Suppl.] 203:135–143, 1968.

    Google Scholar 

  • Hawley, R. J., Major, L. E, Schulman, E. A., and Linnoila, M.: Cerebrospinal fluid 3-methoxy-4-hydroxyphenylglycol and norepinephrine levels in alcohol withdrawal. Arch. Gen. Psychiatry 42:1056–1062, 1985.

    Google Scholar 

  • Heinz, E. R., Martinez, J., and Haenggeli, A.: Reversibility of cerebral atrophy in anorexia nervosa and Cushing’s syndrome. J. Comput. Assist. Tomogr. 1:415–418, 1977.

    Google Scholar 

  • Hill, S. Y., and Mikhael, M. A.: Computerized transaxial tomo-graphic and neuropsychological evaluations in chronic alcoholics and heroin abusers. Am: J. Psychiatry 136:598, 1979.

    Google Scholar 

  • Hirschfelder, A. D., and Haury, V. G.: Clinical manifestations of high and low plasma magnesium. J.A.M.A. 102:1138, 1934.

    Google Scholar 

  • Horrocks, L. A. (ed.): Symposium proceedings on “Neurochemical Consequences of Hepatic Disease,” Neurochemical Pathology 6:1/2, pp. 1–166, April, 1987.

    Google Scholar 

  • Horvath, T. B.: Clinical spectrum and epidemiological features of alcoholic dementia. In: Alcohol, Drugs and Brain Damage (J. G. Rankin, ed.), Toronto, Alcoholism and Drug Addiction Research Foundation of Ontario, 1975, p. 1.

    Google Scholar 

  • Hoyumpa, A. M.: Mechanisms of vitamin deficiencies in alcohol-ism. Alcoholism: Clin. Exp. Res. 10:573–581, 1986.

    Google Scholar 

  • Hughes, J. R., Curtin, M. J., and Brown, V. P.: Usefulness of photic stimulation in routine clinical electroencephalopathy. Neurology (Minneap.) 10:777, 1960.

    Google Scholar 

  • Isbell, H., Fraser, H. F., Wikler, A., Belleville, R. E., and Eisenman, A. S.: An experimental study of the etiology of “rum fits” and delirium tremens. Q. J. Stud. Alcohol 16:1, 1955.

    Google Scholar 

  • Ishii, N., and Nishihara, Y.: Pellagra among chronic alcoholics: Clinical and pathological study of 20 necropsy cases. J. Neurol. Neurosurg. Psychiatry 44:209–215, 1981.

    Google Scholar 

  • Jelliffe, S. E., and White, W. A.: Disease of the Nervous System. Philadelphia, Lea & Febiger, 1929, p. 1066.

    Google Scholar 

  • Jellinek, E. M.: Classics of the alcohol literature: Magnus Huss’ Alcholismus Chronicus. Q. J. Stud. Alcohol 4:85, 1943.

    Google Scholar 

  • Jequier, M., and Wildi, E.: Le syndrome de Marchiafava-Bignami. Schweiz. Arch. Neurol. Neurochir. Psychiatr. 77:393, 1956.

    Google Scholar 

  • Jolliffe, N., Colbert, C. N., and Joffe, P. M.: Observations on the etiologic relationship of vitamin B (B1) to polyneuritis in the alcohol addict. Am. J. Med. Sci. 107:515, 1936.

    Google Scholar 

  • Jolliffe, N., Bowman, K. M., Rosenblum, L. A., and Fein, H. D.: Nicotinic acid deficiency encephalopathy. J.A.M.A. 114:307. 1940.

    Google Scholar 

  • Jolliffe, N., Wortis, H., and Fein, H. D.: The Wernicke syndrome. Arch. Neurol. Psychiatry 46:569, 1941.

    Google Scholar 

  • Kaim, S. C., Klett, C. S., and Rothfeld, B.: Treatment of the acute alcohol withdrawal state: A comparison of four drugs. Am. J. Psychiatry 125:1640–1646, 1969.

    Google Scholar 

  • Kalant, H.: Alcohol and electrophysiology of the central nervous system. In: Advances in Pharmacology and Therapeutics, Drug-Action Modification-Comparative Pharmacology, Vol. 8(G. Olive, ed.), New York, Pergamon Press, 1979, p. 199.

    Google Scholar 

  • Kalant, H., and Woo, N.: Electrophysiological effects of ethanol on the nervous system. Pharmacol. Ther. 14:431–457, 1981.

    Google Scholar 

  • Kalinowsky, L. B.: Convulsions in non-epileptic patients on withdrawal of barbiturates, alcohol, and other drugs. Arch. Neurol. Psychiatry 48:946, 1942.

    Google Scholar 

  • Keller, M.: Other effects of alcohol. In: Drinking and Intoxication: I. Physiological and Psychological Effects of Alcohol (R. G. McCarthy, ed.), Glencoe, IL, Free Press, 1959, p. 13.

    Google Scholar 

  • Keller, M., and Gurioli, C.: Statistics on Consumption of Alcohol and on Alcoholism. New Brunswick, NJ, Rutgers Center for Alcohol Studies, 1976.

    Google Scholar 

  • Keller, M., and McCormick, M.: A Dictionary of Words about Alcohol. New Brunswick, NJ, Rutgers Center for Alcohol Studies, 1982.

    Google Scholar 

  • King, L. S., and Meehan, M. C.: Primary degeneration of the corpus callosum (Marchiafava’s disease). Arch Neural. Psychiatry 36:547, 1936.

    Google Scholar 

  • Klingman, W. O., Suter, C., Green, R., and Robinson, I.: Role of alcoholism and magnesium deficiency in convulsions. Trans. Am. Neurol. Assoc. 80:162, 1955.

    Google Scholar 

  • Kraepelin, E.: Alcoholic mental disturbances. In: Lectures on Clinical Psychiatry (authorized translation from second German edition, revised) (T. Johnstone, ed.), Baltimore, William Wood, 1946, p. 102.

    Google Scholar 

  • Kraus, M. L., Gottlieb, L. D., Horwitz, R. I., and Anscher, M.: Randomized clinical trial of atenolol in patients with alcohol withdrawal. N. Engl. J. Med. 313:905–909, 1985.

    Google Scholar 

  • Krusius, E. E., Vartia, K. O., and Forsander, O.: Experimentelle Studien uber die biologische Wirkung von Alkohol: II. Alkohol and Nebennierenrinden-Funktion. Ann. Med. Exp. Biol. Fenn. 36:424, 1958.

    Google Scholar 

  • Lambert, A.: The intoxicants. In: Textbook of Medicine (3rd edition) (R. Cecil, ed.), Philadelphia, W. B. Saunders, 1934, p. 568.

    Google Scholar 

  • Lance, J. W, and Adams, R. D.: The syndrome of intention or action myoclonus as a sequel to hypoxic encephalopathy. Brain 86:111, 1963.

    Google Scholar 

  • Langenstein, I., Willig, R. P., and Kuhne, D.: Reversible cerebral atrophy caused by corticotrophin. Lancet 1:1246, 1979.

    Google Scholar 

  • Laureno, R.: Central pontine myelinolysis following rapid correc-tion of hyponatremia. Ann. Neurol. 13:232–242, 1983.

    Google Scholar 

  • LeFebvre-D’Amour, M., Shahani, B. T., and Young, R. R.: Tremor in alcoholic patients. In: Physiological Tremor, Patho-logical Tremors and Clonus. (J. E. Desmedt, ed.), Basel, Karger, 1978, pp. 106–164.

    Google Scholar 

  • Lennox, W. G.: Alcohol and epilepsy. Q. J. Stud. Alcohol 2:1, 1941.

    Google Scholar 

  • Lewis, A.: Psychoses—alcoholic psychoses. In: British Encyclo-pedia of Medical Practice, Vol. 10 (2nd ed.) London, Butterworth & Co., 1952, p. 394.

    Google Scholar 

  • Lieber, C. S., and DeCarli, L. M.: Ethanol dependence and tolerance: A nutritionally controlled experimental model in the rat. Res. Commun. Chem. Pathol. Pharmacol. 6:983–991, 1973.

    Google Scholar 

  • Lindenbaum, J., and Lieber, C. S.: Alcohol-induced malabsorption of vitamin B12 in man. Nature 224:806, 1969.

    Google Scholar 

  • Lindenbaum, J., and Lieber, C. S.: Effects of chronic ethanol administration on intestinal absorption in man in the absence of nutritional deficiency. Ann. N.Y. Acad. Sci. 252:228–234, 1975.

    Google Scholar 

  • Lishman, W. A.: Cerebral disorder in alcoholism, syndromes of impairment. Brain 104:1–20, 1981.

    Google Scholar 

  • Lockwood, A. H.: Hepatic encephalopathy: Experimental approaches to human metabolic encephalopathy. CRC Crit. Rev. Neurobiol. 3:105–133, 1987.

    Google Scholar 

  • Luda, E.: Le signe du bobbing oculaire dans l’encephalopathie de Wernicke. Rev. Otoneuroophtalmol. 52:123–125, 1980.

    Google Scholar 

  • MacIntyre, I.: Magnesium metabolism. Adv. Intern. Med. 13:143–154, 1967.

    Google Scholar 

  • Mair, R. G., Capra, C., McEntee, W. J., and Engen, T: Odor discrimination and memory in Korsakoffs psychosis. J. Exp. Psychol. 6:455, 1980.

    Google Scholar 

  • Marchand, L.: Les lesions du systeme nerveux, du foie, des reins et de la rate dans le “delirium tremens” des alcooliques. Ann. Anat. Pathol. 9:1026, 1932.

    Google Scholar 

  • Mathews, T, and Moosy, J.: Central pontine myelinolysis: Lesion evolution and pathogenesis. J. Neuropathol. Exp. Neurol. 34: 77, 1975.

    Google Scholar 

  • Mauritz, K. H., Dichgans, J., and Hufschmidt, A.: Quantitative analysis of stance in late cortical cerebellar atrophy of the anterior lobe and other forms of cerebellar ataxia. Brain 102: 461–482,1979.

    Google Scholar 

  • Mayer, R. E: Peripheral nerve conduction in alcoholics. Psychosom. Med. 28:475, 1966.

    Google Scholar 

  • McDermott, W. V., and Adams, R. D.: Episodic stupor associated with an Eck fistula in the human with particular reference to the metabolism of ammonia. J. Clin. Invest. 33:1, 1954.

    Google Scholar 

  • McDougall, W.: On a new method for the study of concurrent mental operations and of mental fatigue. Br. J. Psychol. 1: 435, 1904.

    Google Scholar 

  • McDowell, J. R., and LeBlanc, H. J.: Computed tomographic findings in Wernicke-Korsakoff syndrome. Arch. Neurol. 41: 453–454,1984.

    Google Scholar 

  • McEntee, W. J., Mair, R. G., and Langlais, P. J.: Neurochemical pathology in Korsakoff’s psychosis: Implications for other cognitive disorders. Neurology (N.Y..) 34:648–652, 1984.

    Google Scholar 

  • McKee, A. C., Winkelman, M. D., and Banker, B. Q.: Central pontine myelinolysis in severely burned patients: Relationship to serum hyperosmolality. Neurology 38:1221, 1988.

    Google Scholar 

  • McQuarrie, D. G., and Fingl, E.: Effects of single doses and chronic administration of ethanol on experimental seizures in mice. J. Pharmacol. Exp. Ther. 124:264, 1958.

    Google Scholar 

  • Mello, N. K.: Short-term memory function in alcohol addicts during intoxication. In: Alcohol Intoxication and Withdrawal: Experimental Studies, Proceedings 39th International Congress on Alcoholism and Drug Dependence (M. M. Gross, ed.), New York, Plenum Press, 1973. p. 333.

    Google Scholar 

  • Mello, N. K.: Animal models for the study of alcohol addiction. Psychoneuroendocrinology 1:347, 1976.

    Google Scholar 

  • Mendelson, J. H., and LaDou, J.: Experimentally induced chronic intoxication and withdrawal in alcoholics: II. Psychophysiological findings. Q. J. Stud. Alcohol (Suppl.) 2:14, 1964.

    Google Scholar 

  • Mendelson, J. H., and Mello, N. K.: Basic mechanisms underlying physical dependence upon alcohol. Ann. N.Y. Acad. Sci. 311:69, 1978.

    Google Scholar 

  • Mendelson, J. H., Wexler, D., Kubzansky, P., Leiderman, P. H., and Solomon, P.: Serum magnesium in delirium tremens and alcoholic hallucinosis. J. Nerv. Ment. Dis. 128:352, 1959.

    Google Scholar 

  • Mensing, J. W. A., Hoogland, P. H., and Slooff, J. L.: Computer tomography in the diagnosis of Wernicke’s encephalopathy: A radiologic-neuropathologic correlation. Ann. Neurol. 16: 363, 1984.

    Google Scholar 

  • Mezey, E., Jow, E., Slavin, R. E., and Tobon, F.: Pancreatic function and intestinal absorption in chronic alcoholism. Gastroenterology 59:657, 1970.

    Google Scholar 

  • Miles, W. R.: Effect of Alcohol on Psychophysiological Functions (Publication 266). Washington, D.C., Carnegie Institute of Washington, 1918.

    Google Scholar 

  • Miles, W. R.: Psychological effects of alcohol on man. In: Alcohol and Man (H. Emerson, ed.), New York, Macmillan, 1932, p. 224.

    Google Scholar 

  • Miller, R. M., and Hunt, J. A.: The radiologic features of alcoholic ulcer-osteolytic neuropathy in blacks. S. Afr. Med. J. 54:159–161, 1978.

    Google Scholar 

  • Minot, G. R., Strauss, M. B., and Cobb, S.: “Alcoholic” poly-neuritis: Dietary deficiency as a factor in its production. N. Engl. J. Med. 208:1244, 1933.

    Google Scholar 

  • Morel, F: Une forme anatomoclinique particuliere de l’alcoolisme chronique cliniquement rappelant la pseudo-paralysie des anciens auteurs, anatomiquement présentant une sclérose corticale laminaire. Schweiz. Arch. Neurol. Psychiatr. 44: 305, 1939.

    Google Scholar 

  • Mukherjee, A. B., Svoronos, S., Ghazanfari, A., Martin, P. R., Fisher, A., Roecklein, B., Rodbard, D., Staton, R., Behar, D., and Berg, C. J.: Transketolase abnormality in cultured fibroblasts from familial chronic alcoholic men and their male offspring. J. Clin. Invest. 79:1039–1043, 1987.

    Google Scholar 

  • Novak, D. J., and Victor, M.: Affection of the vagus and sympathetic nerves in alcoholic polyneuropathy. Arch. Neurol. 30: 273–284,1974.

    Google Scholar 

  • Noyes, A. P.: Modern Clinical Psychiatry (2nd ed.). Philadelphia, W. B. Saunders, 1939.

    Google Scholar 

  • Okuno, T, Ito, M., Konishi, Y., Yoshioka, M., and Nakano, Y.: Cerebral atrophy following ACTH therapy. J. Comput. Assist. Tomogr. 4:20–23, 1980.

    Google Scholar 

  • Osier, W.: Principles and Practice of Medicine (8th ed.). New York, Appleton, 1917, p. 398.

    Google Scholar 

  • Palsson, A.: The efficacy of early chlormethiazole medication in the prevention of delirium tremens. A retrospective study of the outcome of different drug treatment strategies at the Helsingborg psychiatric clinics, 1975–1980. Acta Psychiatr. Scand. [Suppl]. 329 (73):140–145, 1986.

    Google Scholar 

  • Perr, I. N.: Pathological intoxication and alcohol idiosyncratic intoxication. I. Diagnostic and clinical aspects. J. Forensic. Sci. 31:806–811, 1986.

    Google Scholar 

  • Phillips, G. B., Schwartz, R., Gabuzda, G. J., and Davidson, C. S.: The syndrome of impeding hepatic coma in patients with cirrhosis of the liver given certain nitrogenous substances. N. Engl. J. Med. 247:239, 1952.

    Google Scholar 

  • Phillips, S. C., Cragg, B. G., and Singh, S. C.: The short-term toxicity of ethanol to neurons in rat cerebral cortex tested by topical application in vivo and a note on a problem in estimating ethanol concentrations in tissue. J. Neurol. Sci. 49:353–361, 1981.

    Google Scholar 

  • Piker, P.: On the relationship of sudden withdrawal of alcohol to delirium tremens. Am. J. Psychiatry 93:1387, 1937.

    Google Scholar 

  • Plum, F., and Posner, J. B.: The Diagnosis of Stupor and Coma,3rd ed., Philadelphia, F. A. Davis, 1980, p. 2.

    Google Scholar 

  • Pohorecky, L. A.: Biphasic action of alcohol. Biobehay. Rev. 1: 231, 1977.

    Google Scholar 

  • Porter, R. J., Mattson, R. H., Cramer, J. A., and Diamond, I. (eds.): Alcohol and Seizures, Philadelphia, F. A. Davis, 1990, pp. 25–139.

    Google Scholar 

  • Potts, A. M.: Tobacco amblyopia. Sun. Ophthalmol. 17:313–319, 1973.

    Google Scholar 

  • Projesz, B., and Begleiter, H.: Brain dysfunction and alcohol. In: The Biology of Alcoholism, Vol. 7 (B. Kissen and H. Begleiter, eds.), New York, Plenum Press, 1983, p. 449.

    Google Scholar 

  • Randall, R. E., Rossmeisl, E. C., and Bleifer, K. H.: Magnesium depletion in man. Ann. Intern. Med. 50:257, 1959.

    Google Scholar 

  • Rice, J. P., Horowitz, M., and Chin, D.: Wernicke-Korsakoff syndrome with bilateral facial nerve palsies. J. Neurol. Neurosurg. Psychiatry 47:1356–1357, 1984.

    Google Scholar 

  • Riley, J. N., and Walker, D. W.: Morphological alterations in hippocampus after long-term alcohol consumption in mice. Science 201:646–648, 1978.

    Google Scholar 

  • Rivers, W. H. R.: The Influence of Alcohol and Other Drugs on Fatigue. London, Edward Arnold, 1908.

    Google Scholar 

  • Roche, S. W., Lane, R. J. M., and Wade, J. P. H.: Thalamic hemorrhages in Wernicke-Korsakoff syndrome demonstrated by computed tomography. Ann. Neurol. 23:312, 1988.

    Google Scholar 

  • Ron, M. A., Acker, W, Shaw, G. K., and Lishman, W. A.: Computerized tomography of the brain in chronic alcoholism. A survey and follow-up study. Brain 105:497–514, 1982.

    Google Scholar 

  • Ronthal, M., and Adler, H.: Motor nerve conduction velocity and the electromyograph in pellagra. S. Afr. Med. J. 43:642–644, 1969.

    Google Scholar 

  • Said, G.: A clinicopathologic study of acrodystrophic neuropathies. Muscle Nerve 3:491–501, 1980.

    Google Scholar 

  • Said, G. and Landrieu, P: Etude quantitative des fibres nerveuses isolees dans les polynevrites alcooliques. J. Neurol. Sci. 35:317–330, 1978.

    Google Scholar 

  • Sandri, R., Bruschi, M., and Conte, L.: Le ulcere perforanti plantari nelle polyneuriti alcooliche. Minerva Med. 67:2919–2926,1976.

    Google Scholar 

  • Schuckit, M. A., and Winokur, G.: Alcoholic hallucinosis and schizophrenia: A negative study. Br. J. Psychiatry 119:549–550, 1971.

    Google Scholar 

  • Schwartz, R., Phillips, G. B., Seegmiller, E., Gabuzda, G. J., and Davidson, C. S.: Dietary protein in the genesis of hepatic coma. N. Engl. J. Med. 251:685, 1954.

    Google Scholar 

  • Scott, D. F.: Alcoholic hallucinosis: An aetiological study. Br. J. Addict. 62:113–125, 1967.

    Google Scholar 

  • Sellers, E. M., and Kalant, H.: Alcohol intoxication and withdrawal. N. Engl. J. Med. 294:757–762, 1976.

    Google Scholar 

  • Sellers, E. M., Naranjo, C. A., Harrison, M., Devenyi, P, Roach, C., and Sykora, K.: Diazepam loading: Simplified treatment of alcohol withdrawal. Clin. Pharmacol. Ther. 34:822–826, 1983.

    Google Scholar 

  • Seltzer, B., and Sherwin, I.: “Organic brain syndromes”: An empirical study and critical review. Am. J. Psychiatry 135: 13–21, 1978.

    Google Scholar 

  • Serdaru, M., Hausser-Hauw, C., Laplane, D., Buge, A., Castaigne, P., Goulon, M., Lhermitte, F., and Hauw, J. J.: The clinical spectrum of alcoholic pellagra encephalopathy. Brain 111:829–842, 1988.

    Google Scholar 

  • Sereny, G., Rapoport, A., and Husdan, H.: The effect of alcohol withdrawal on electrolyte and acid-base balance. Metabolism 15:896–904, 1966.

    Google Scholar 

  • Shah, D. R., Singh, S. V, and Jain, I. L.: Neurological manifestations in pellagra. J. Assoc. Physicians India 19:443–446, 1971.

    Google Scholar 

  • Sherlock, S., Sumtnerskill, W. H. J., White, L. P., and Phear, E. A.: Portal-systemic encephalopathy: Neurological complications of liver disease. Lancet 2:453, 1954.

    Google Scholar 

  • Shimojyo, S., Scheinberg, P, and Reinmuth, O.: Cerebral blood flow and metabolism in the Wernicke-Korsakoff syndrome. J. Clin. Invest. 46:849–854, 1967.

    Google Scholar 

  • Smith, J. J.: The treatment of acute alcoholic states with ACTH and adrenocortical hormones. Q. J. Stud. Alcohol 11:190, 1950.

    Google Scholar 

  • Spies, T. D., and DeWolfe, H. F.: Observation on etiological relationship of severe alcoholism to pellagra. Am. J. Med. Sci. 186:521, 1933.

    Google Scholar 

  • Spillane, J. D.: Nutritional Disorders of the Nervous System. Baltimore, Williams & Wilkins, 1947, p. 48.

    Google Scholar 

  • Spivak, J. L., and Jackson, D. L.: Pellagra: An analysis of 18 patients and a review of the literature. Johns Hopkins Med. J. 140:295–309, 1977.

    Google Scholar 

  • Squire, L. R., Amaral, D. G., and Press, G. A.: Magnetic resonance imaging of the hippocampal formation and mammillary nuclei distinguish medial temporal lobe and dien-cephalic amnesia. J. Neurosci. 10:3106–3117, 1990.

    Google Scholar 

  • Strecker, E. A., Ebaugh, E G., and Ewalt, J. R.: Practical Clinical Psychiatry. New York, Blakiston, 1951, pp. 150, 155, and 169.

    Google Scholar 

  • Suter, C., and Klingman, W: Neurologic manifestations of magne-sium depletion states. Neurology (Minneap.) 4:691, 1955.

    Google Scholar 

  • Tamerin, J. S., Weiner, S., Poppen, R., Steinglass, P, and Mendelson, J. H.: Alcohol and memory: Amnesia and short-term memory function during experimentally-induced intoxication. Am. J. Psychiatry 127:1659–1664, 1971.

    Google Scholar 

  • Tashiro, K., and Nelson, J. S.: Hemorrhagic necrosis of superior cerebellar vends associated with acute Wernicke’s encephalopathy. J. Neuropathol. Exp. Neurol. 31:185, 1972.

    Google Scholar 

  • Tewari, S., and Noble, E. P: Effect of ethanol on cerebral protein and ribonucleic acid synthesis. In: Biochemistry and Phar-macology of Ethanol (E. Majchrowicz and E. P. Noble, eds.), New York, Plenum Press, 1979, p. 541.

    Google Scholar 

  • Thomson, A., Baker, H., and Leevy, C. M.: Thiamine absorption in alcoholism. Am. J. Clin. Nutr. 21:537, 1968.

    Google Scholar 

  • Thornhill, H. L., Richter, R. W, Shelton, M. L., and Johnson, C. A.: Neuropathic arthropathy (Charcot forefeet) in alcoholics. Orthop. Clin. North Am. 4:7–20, 1973.

    Google Scholar 

  • Tomasulo, P. A., Kater, R. M. H., and Iber, E. L.: Impairment of thiamine absorption in alcoholism. Am. J. Clin. Nutr. 21: 1341–1344,1968.

    Google Scholar 

  • Tomlinson, B., Pierides, A., and Bradley, W.: Central pontine myelinolysis: Two cases associated with electrolyte disturbance. Q. J. Med. (N. Ser.) 45:373, 1976.

    Google Scholar 

  • Vallee, B. L., Wacker, E. C., and Ulmer, D. D.: The magnesium deficiency tetany syndrome in man. N. Engl. J. Med. 262: 155, 1960.

    Google Scholar 

  • Victor, M.: Tobacco-alcohol amblyopia: A critique of current concepts of this disorder, with special reference to the role of nutritional deficiency in its causation. Arch. Ophthalmol. 70: 313, 1963.

    Google Scholar 

  • Victor, M.: Treatment of alcoholic intoxication and the withdrawal syndrome: A critical analysis of the use of drugs and other forms of therapy. Psychosom. Med. 28:636, 1966.

    Google Scholar 

  • Victor, M.: The pathophysiology of alcoholic epilepsy. Res. Publ. Assoc. Res. Nerv. Ment. Dis. 46:431–454, 1968.

    Google Scholar 

  • Victor, M.: Tobacco, amblyopia, cyanide poisoning and vitamin B12 deficiency: A critique of current concepts. In: Miami Neuro-Ophthalmology Symposium, Vol. 5 (J. L. Smith, ed.), Hallandale, FL, Huffman, 1970, pp. 33–48.

    Google Scholar 

  • Victor, M.: The role of hypomagnesemia and respiratory alkalosis in the genesis of alcohol-withdrawal symptoms. Ann. N.Y. Acad. Sci. 215:235–248, 1973.

    Google Scholar 

  • Victor, M.: Polyneuropathy due to nutritional deficiency and alcoholism. In: Peripheral Neuropathy (2nd ed.) (P J. Dyck, P K. Thomas, E. H. Lambert, and R. Bunge, eds.), Philadelphia, W. B. Saunders, 1984, p. 1899.

    Google Scholar 

  • Victor, M.: Neurologic disorders due to alcoholism and malnutrition. In: Clinical Neurology (A. B. Baker, and R. J. Joynt, eds.), Philadelphia, Harper and Row, vol. 4, Chap. 61, 1986.

    Google Scholar 

  • Victor, M.: MR in the diagnosis of the Wernicke—Korsakoff syndrome. Am. J. Neuroradiol. 11:895–896, 1990.

    Google Scholar 

  • Victor, M., and Adams, R. D.: The effect of alcohol upon the nervous system. Res. Publ. Assoc. Res. Nerv. Ment. Dis. 32: 526, 1953.

    Google Scholar 

  • Victor, M., and Adams, R. D.: Neuropathy of experimental vitamin B6 deficiency in monkeys. Am. J. Clin. Nutr. 4:346, 1956.

    Google Scholar 

  • Victor, M., and Adams, R. D.: On the etiology of the alcoholic neurologic diseases: With special seferences to the role of nutrition. Am. J. Clin. Nutr. 9:379, 1961.

    Google Scholar 

  • Victor, M., and Adams, R. D.: The alcoholic dementias. In: Handbook of Clinical Neurology, Neurobehavioral Disorders, Vol. 2 (P J. Vinken, G. W. Bruyn, and H. L. Klawans, eds.), Amsterdam, Elsevier, 1985, pp. 335–352.

    Google Scholar 

  • Victor, M., and Brausch, C. C.: The role of abstinence in the genesis of alcoholic epilepsy. Epilepsia 8:1–20, 1967.

    Google Scholar 

  • Victor, M., and Dreyfus, P. M.: Tobacco-alcohol amblyopia: Further comments on its pathology. Arch. Ophthalmol. 74:649, 1965.

    Google Scholar 

  • Victor, M., and Ferrendelli, J. A.: The nutritional and metabolic diseases of the cerebellum: Clinical and pathological aspects. In: The Cerebellum in Health and Diseases (W. S. Fields and W. D. Willis, eds.), St. Louis, Warren H. Green, 1970, p. 412.

    Google Scholar 

  • Victor, M., and Hope, J. M.: The phenomenon of auditory hallucinations in chronic alcoholism. J. Nerv. Ment. Dis. 126:451, 1957.

    Google Scholar 

  • Victor, M., and Laureno, R.: The neurologic complications of alcohol abuse: Epidemiologic aspects. Adv. Neurol. 19:603–617, 1978.

    Google Scholar 

  • Victor, M., and Yakovlev, P. I.: S. S. Korsakoff’s psychic disorder in conjunction with peripheral neuritis: A translation of Korsakoff’s original article with brief comments on the author and his contribution to clinical medicine. Neurology (Min-neap.) 5:394, 1955.

    Google Scholar 

  • Victor, M., Adams, R. D., and Mancall, E. L.: A restricted form of cerebellar degeneration occurring in alcoholic patients. Arch. Neurol. 1:577, 1959.

    Google Scholar 

  • Victor, M. Mancall, E. L. and Dreyfus, P. M.: Deficiency amblyopia in the alcoholic patient: A clinicopathologic study. Arch. Opthtahalmol. 64:1, 1960.

    Google Scholar 

  • Victor, M., Adams, R. D., and Cole, M.: The acquired (nonWilsonian) type of chronic hepatocerebral degeneration. Medicine 44:345, 1965.

    Google Scholar 

  • Victor, M., Adams, R. D., and Collins, G. H.: The Wernicke-Korsakoff Syndrome. A Clinical and Pathological Study of 245 Patients, 82 with Postmortem Examinations (2nd ed., revised.) Philadelphia, E. A. Davis, 1989.

    Google Scholar 

  • Wacker, W. E. C., and Vallee, B. L.: Magnesium metabolism. N. Engl. J. Med. 259:431, 1958.

    Google Scholar 

  • Wechsler, I. S.: Etiology of polyneuritis. Arch. Neurol. Psychiatry 29:813, 1933.

    Google Scholar 

  • Wernicke, C.: Grundriss der Psychiatrie. Leipzig, Thieme, 1900.

    Google Scholar 

  • Wilder, A., Pescor, E. T., Fraser, H. E, and Isbell, H.: Electroencephalographic changes associated with chronic alcoholic intoxication and the alcohol abstinence syndrome. Am. J. Psychiatry 113:106, 1956.

    Google Scholar 

  • Wilkinson, D. A.: Accelerated mental aging in alcoholism: Working hypothesis or uncontrolled variable? In: Cerebral Defects in Alcoholism (D. A. Wilkinson, ed.), Toronto, Addiction Research Foundation, 1982, p. 61.

    Google Scholar 

  • Wilkinson, I. M. S., and Kime, R.: Alcohol and human eye movement. Trans. Am. Neurol. Assoc. 99:38–41, 1974.

    Google Scholar 

  • Winship, D. H., Caffisch, C. R., Zboralske, E. E, and Hogan, W. J.: Deterioration of esophageal peristalis in patients with alcoholic neuropathy. Gastroenterology 55:173–178, 1968.

    Google Scholar 

  • Wolfe, S. M., and Victor, M.: The relationship of hypomagnesemia and alkalosis to alcohol withdrawal symptoms. Ann. N.Y. Acad. Sci. 162:973–984, 1969.

    Google Scholar 

  • Wolfe, S. M., and Victor, M.: The physiological basis of the alcohol withdrawal syndrome. In: Recent Advances in Studies of Alcoholism (N. K. Mello and J. H. Mendelson, eds.), Washington, U.S. Government Printing Office, 1971, p. 188.

    Google Scholar 

  • Wolfe, S. M., Mendelson, J. H., Ogato, M., Victor, M., Marshall, W, and Mello, N.: Respiratory alkalosis and alcohol with-drawal. Trans. Assoc. Am. Physicians 82:344–352, 1969.

    Google Scholar 

  • Wortis, H., Wortis, S. B., and Marsh, E. I.: Vitamin C studies in alcoholics. Am. J. Psychiatry 94:891, 1938.

    Google Scholar 

  • Wright, D., Laureno, R., and Victor, M.: Pontine and extrapontine myelinolysis. Brain 102:361, 1979.

    Google Scholar 

  • Zieve, L.: Pathogenesis of hepatic encephalopathy. Metab. Brain Dis. 2:147–165, 1987.

    Google Scholar 

  • Zilm, D. H., Sellers, E. M., MacLeod, S. M., and Degani, N.: Letter: Propranolol effect on tremor in alcoholic withdrawal. Ann. Intern. Med. 83:234–236, 1975.

    Google Scholar 

  • Zipursky, R. B., Lim, K. O., and Pfefferbaum, A.: MRI study of brain changes with short-term abstinence from alcohol. Alcohol Clin. Exp. Res. 13:664–666, 1989.

    Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer Science+Business Media New York

About this chapter

Cite this chapter

Victor, M. (1992). The Effects of Alcohol on the Nervous System. In: Medical and Nutritional Complications of Alcoholism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3320-7_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-3320-7_14

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-6462-7

  • Online ISBN: 978-1-4615-3320-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics