Early-Onset Alcohol Dependence and Multiple Sclerosis: Diagnostic Challenges

Maria Luca, Clara Grazia Chisari, Aurora Zanghì and Francesco Patti
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Maria Luca: Section of Neurosciences, Department “GF. Ingrassia”, University of Catania, Via S. Sofia, 78, 95123 Catania, Italy
Clara Grazia Chisari: Section of Neurosciences, Department “GF. Ingrassia”, University of Catania, Via S. Sofia, 78, 95123 Catania, Italy
Aurora Zanghì: Section of Neurosciences, Department “GF. Ingrassia”, University of Catania, Via S. Sofia, 78, 95123 Catania, Italy
Francesco Patti: Section of Neurosciences, Department “GF. Ingrassia”, University of Catania, Via S. Sofia, 78, 95123 Catania, Italy

IJERPH, 2021, vol. 18, issue 11, 1-6

Abstract: Multiple sclerosis (MS) is an inflammatory demyelinating disorder characterized by the progressive disruption of the myelin sheath around the nerve fibres. The early initiation of disease-modifying treatments is crucial for preventing disease progression and neurological damage. Unfortunately, a diagnostic delay of several years is not uncommon, particularly in the presence of physical and mental comorbidities. Among psychiatric comorbidities, the role of alcohol misuse is still under debate. In this paper, we discuss a case of early-onset alcohol dependence and its possible role in delaying the initiation of a specific therapy for MS. The differential diagnosis between idiopathic and secondary neurodegenerative disorders is often challenging. When dealing with patients reporting an early-onset substance abuse (likely to present organic damage), clinicians may be prone to formulate a diagnosis of secondary neuropathy, particularly when facing non-specific symptoms. This case report highlights the need for in-depth medical investigations (including imaging) in the presence of neurological signs suggesting a damage of the central nervous system, prompting a differential diagnosis between idiopathic and secondary neurodegenerative conditions. Indeed, a timely diagnosis is crucial for the initiation of specific therapies positively affecting the outcome.

Keywords: multiple sclerosis; alcohol dependence; differential diagnosis; diagnostic delay (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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