Alcoholic Myelopathy Without Substantial Liver Disease: A Syndrome of Progressive Dorsal and Lateral Column Dysfunction

• Five well-nourished, alcoholic patients had a progressive myelopathy. Symptoms began with paresthesias of the feet and progressed to a spastic paraparesis with clinical signs of both lateral and dorsal column involvement. Abstinence from alcohol halted progression but did not cause improvement in the myelopathy. The absence of portacaval shunting or notable liver dysfunction in these patients suggests that a direct toxic effect of alcohol must be considered a possible mechanism of spinal cord damage.