Autonomic dysfunction in long-standing alcoholism.

Twenty-eight male alcoholics were studied for peripheral sensory-motor and autonomic neuropathy. The patients were examined neurologically and neurophysiologically after a period of withdrawal treatment in hospital. The function tests of the autonomic nervous system performed were: measurement of the variation of the heart rate at rest and during maximal breathing, Valsalva manoeuvre, postural pulse and blood pressure reactions, and isometric test. Slight abnormalities in the peripheral nervous system were observed in 8 patients, but a frank clinical polyneuropathy supported by neurophysiological findings could be diagnosed only in 2. All of the parameters which reflect the function of the parasympathetic division of the autonomic nervous system were lower in the alcoholics compared with the controls. The most sensitive variables were the heart rate variation at rest, and the postural pulse reaction. The functions mediated by the sympathetic nervous system were not abnormal among this group of alcoholics.