• Numbness in the arms and legs
• Abnormal sensations; "pins and needles"
• Painful sensations in the arms and legs
• Muscle weakness
• Muscle cramps or muscle aches
• Heat intolerance, especially after exercise
• Impotence (in men)
• Problems urinating
  • Incontinence (leaking urine)
  • Feeling of incomplete bladder emptying
  • Difficulty beginning to urinate
• Constipation
• Diarrhea
• Nausea, vomiting

Additional symptoms that may occur with this disease:

• Swallowing difficulty
• Speech impairment
• Loss of muscle function or feeling
• Muscle contractions or spasm
• Muscle atrophy
• Problems with movements

Note: Changes in muscle strength or sensation usually occur on both sides of the body and are more common in the legs than in the arms. Symptoms usually develop gradually and slowly become worse over time.

Your doctor will get an extensive description of the problem and will perform a neurological exam. Signs may include:

• Weakness
• Numbness to touch
• Loss of reflexes (such as the knee jerk)

Neurological problems usually affect both sides of the body in this condition.

An eye exam may show decreased pupil response or other problem. Blood pressure may fall when you stand up.

Alcoholism often causes nutritional deficiency. This is because people drink excessively instead of eating properly, and because some vitamins and minerals are used up or lost due to the alcohol. Nutritional studies may show deficiencies of:

• Thiamine (vitamin B1)
• Pyridoxine (vitamin B6)
• Pantothenic acid and biotin
• Vitamin B12
• Folic acid
• Niacin (vitamin B3)
• Vitamin A

Additional tests may be done to rule out other possible causes of neuropathy. Tests may include:

• Serum electrolyte levels
• Studies of kidney and liver function
• Thyroid function tests
• Levels of vitamins and minerals in the body
• Nerve conduction tests
• Electromyography (EMG)
• Nerve biopsy
• Upper GI and small bowel series
• Esophagogastroduodenoscopy (EGD)
• Isotope studies of gastrointestinal function
• Voiding cystourethrogram