Symptoms:

• 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
• Movement disorders

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.

Signs and tests:

Your health care provider will perform a physical exam and ask questions about your symptoms. An eye exam may show eye problems.

Alcoholism often makes your body unable to use or store certain vitamins and minerals. Blood tests will be done to check for a deficiency (lack 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:

• Electrolyte levels
• Electromyography (EMG)
• Liver and kidney function tests
• Thyroid function tests
• Levels of vitamins and minerals in the body
• Nerve conduction tests
• Nerve biopsy
• Upper GI and small bowel series
• Esophagogastroduodenoscopy (EGD)
• Voiding cystourethrogram