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Alcoholic neuropathy is a primary axonal neuropathy characterized by wallerian degeneration of the axons and a reduction in the myelination of neural fibers. 7 Controversy surrounds the pathogenic role of alcohol in development of this neuropathy. Studies on rat models have indicated that alcohol does have a directly neurotoxic effect on spinal cord and neuronal organelles. 8, 9 Acetaldehyde, a metabolite of ethanol (ETOH), has a direct neurotoxic effect. Motor symptoms include muscle weakness, cramps and spasms, particularly in the lower limbs.