It is usually also associated with nutritional deficiencies and may be indistinguishable from nutritional-related neuropathies such as beriberi . Habitual alcohol use , prolonged heavy use of alcohol, or alcoholism that is present for 10 years or more indicate high risk for alcoholic neuropathy. Total abstinence from alcohol may be necessary for persons with alcoholism . Symptoms may develop gradually and progressively worsen over weeks to years.
Neurologic deficits are usually symmetrical.
Signs of autonomic dysfunction may be present. Eye inspection may show decreased pupil response or other abnormality. Lab tests may be performed as indicated by the history, signs, and symptoms to rule out other possible causes of neuropathy. An upper GI and small bowel series may show decreased motility, delayed emptying of the stomach, or other abnormalities. Other tests may be performed to determine the presence and extent of other neurologic losses.