Alcohol-related brain damage

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at August 3, 2016
StartDiseasesAlcohol-related brain damage

Alcoholics face many health challenges, including alcohol-related brain damage (ARBD), which is also known as alcohol-related brain impairment (ARBI). If treated with abstinence from alcohol, this type of brain damage usually does not worsen and is partially reversible. As is the case with other health problems associated with alcoholism, it is also highly preventable.


Definition & Facts

Alcohol-related brain damage is an umbrella term like arthritis that describes several different types of syndromes and medical conditions caused by drinking too much alcohol. A patient is diagnosed with one of those conditions rather than just ARBD or ARBI.

Conditions that fall under the alcohol-related brain damage umbrella include alcohol-related dementia, cerebellar ataxia, and Korsakoff 's syndrome. There is another condition caused by a heavy drinker undergoing withdrawal called Wernicke's encephalopathy which also causes ARDB symptoms.

Symptoms & Complaints

Alcoholics with alcohol-related brain damage show a wide variety of physical symptoms and changes in behavior. A doctor or neurologist may not be alarmed by one symptom but will consider alcohol-related brain damage when a whole cluster of symptoms appear.

Physical symptoms include loss of coordination, difficulty talking, inability to control eye movements (nystagmus), a constant pins and needles feeling (as when a body part wakes up from sleep) on one or more areas (paresthesia), constant numbness in one or more areas, chronic constipation or diarrhea, impotence, muscle cramps, spasms and becoming dangerously thin.

Behavioral changes include sudden aggression, deep depression, inability to learn or perform tasks that used to be simple, total lack of interest in sex, and impulsive behaviors that involve acting out.

However, the most common symptom of alcohol-related brain damage is amnesia or forgetting far more often than usual. The alcoholic forgets far more than he or she would during a typical blackout that causes memory loss of the night before. He or she with alcohol-related dementia may forget so much that he or she cannot function in everyday life. Holding down a job or caring for family members can become impossible.


Alcohol-related brain damage is caused in two main ways:

  • Drinking heavily over many years
  • Binge drinking or habitually drinking more than four drinks in one short drinking session over a long period of time.

Alcohol damages the brain in many ways. First, it interferes with the body's ability to absorb the vitamin, thiamine (B1) which the brain needs in order to function properly. Alcohol also interferes with normal blood circulation so that the brain does not receive necessary amounts of blood.

Alcohol can also cause weight gain which puts strain on the heart. This makes it harder for the heart to keep blood flowing everywhere to the body, including the brain. Alcohol also damages nerve cells in the brain which can affect coordination and cause behavior changes.

Alcoholics tend to get into fights or fall down which can cause traumatic head injuries that can further damage the brain. Women are far more likely to start showing symptoms of alcohol-related brain damage than men because women's bodies cannot metabolize alcohol as well as men's bodies.

Diagnosis & Tests

There is no one test that simply and accurately diagnoses alcohol-related brain damage. Patients showing symptoms may need to undergo neuroimaging studies to make sure they do not suffer from other problems that can cause the exact same symptoms of alcohol-related brain damage such as a brain tumor or stroke.

A doctor or neurologist needs to know all of the medications and drugs a patient is taking to be sure that he or she is not suffering from side effects of medicines or drugs and not alcohol. If a patient stops drinking and the alcohol-related brain damage symptoms decrease, a doctor may conclude that a patient has alcohol-related brain damage. Patients may undergo neuropsychological tests such as memory tests to determine if they have dementia and if so, how bad the dementia is.

Treatment & Therapy

There are many kinds of treatment available for individuals with alcohol-related brain damage, but no drug, diet regime or memory exercise program can help unless an alcoholic stops drinking. This is where psychotherapy (talk therapy) is helpful. Alcoholics can explore why they drink and find other ways to cope with psychological stress other than the bottle.

Many alcoholics benefit from support groups such as twelve-step programs like Alcoholics Anonymous which encourage alcoholics to share stories of successes and failures. Such groups let an alcoholic trying to stay sober know that he or she is not alone. These groups provide social support and accountability.

Medications can help specific symptoms like the numbness or pins and needles feelings but there is no drug, surgery, or cure for alcohol-related brain damage. Alcoholics are encouraged to eat a balanced diet because they often do not eat properly or at all when drinking. Alcoholics will be encouraged to take vitamin B1 supplements along with eating foods rich in B vitamins.

People with alcohol-related brain damage symptoms often do not get worse when they stop drinking and follow their doctor's advice. Some brain-scan studies even show that the brain can repair itself or compensate for damage caused by alcohol.

Prevention & Prophylaxis

The only known way to successfully prevent alcohol-related brain damage is to never drink or to only use alcohol in moderation. For men, drinking two or fewer drinks a day (every 24 hours) lessens the chance of getting alcohol-related brain damage, according to the Centers for Disease Control and Prevention.

Women should only have at the most one drink per day. Teenagers should not start drinking because their brains and bodies are still developing.

Heavy drinkers should not quit suddenly without the help of a doctor because they will be at high risk of negative health consequences as a result of alcohol withdrawal. Delirium tremens and Wernicke's encephalopathy are conditions that can result from alcohol withdrawal without medical supervision. Alcoholics detoxifying may need to be hospitalized and put on a round of sedatives to help offset severe withdrawal symptoms such as seizures and hallucinations.