Overcoming Ataxia at 65: How Quitting Alcohol Transformed One Man's Health

A Life-Changing Diagnosis in Later Years

In this real-life medical case, a 65-year-old man with a decades-long history of heavy alcohol consumption faced a sudden and alarming decline in his mobility. For over 20 years, he had consumed approximately 250 grams of alcohol daily—equivalent to nearly half a liter of strong spirits. What began as occasional unsteadiness while walking was initially dismissed as the effects of intoxication. However, when the imbalance persisted even after abstaining from drinking, it became clear that something more serious was occurring. This prompted a visit to Shandong Provincial Third Hospital, where advanced imaging and laboratory tests led to a definitive diagnosis: subacute combined degeneration of the spinal cord (SCD).

This neurological condition, often linked to vitamin B12 deficiency and exacerbated by chronic alcohol use, damages the spinal cord and leads to symptoms such as ataxia—loss of coordination and balance. Fortunately, with timely intervention, proper treatment, and complete abstinence from alcohol, significant recovery is possible. This article explores the patient's journey, treatment plan, and the pivotal role quitting alcohol played in his rehabilitation.

Patient Profile and Clinical Presentation

Key Information at a Glance

Gender: MaleAge: 65Primary Diagnosis: Subacute Combined Degeneration of the Spinal CordHospital: Shandong Provincial Third HospitalDate of Admission: January 2021Treatment Duration: 14 days inpatient care, followed by outpatient follow-up one month laterTreatment Approach: High-dose vitamin B12 therapy, oral supplements (B12, folic acid, iron), nutritional support, and strict alcohol cessationOutcome: Marked improvement in motor function and stability; stabilized neurological status

Initial Assessment: Recognizing the Warning Signs

When the patient first arrived at the clinic, clinicians immediately noticed signs of poor nutrition and a distinct odor of alcohol. Despite attempts to reduce his intake by switching to lower-proof beverages, he continued experiencing progressive gait instability. Notably, the dizziness and stumbling did not resolve after stopping alcohol completely, indicating an underlying neurological issue rather than mere intoxication.

Neurological examination revealed normal consciousness and muscle tone but positive results on key coordination tests—specifically, the finger-to-nose test and tandem gait test—both indicative of cerebellar or sensory ataxia. Based on these findings, the preliminary diagnosis was ataxia of unknown origin, necessitating further investigation to rule out stroke, brain tumors, peripheral neuropathy, or spinal cord disorders.

Diagnostic Workup and Confirmation

To pinpoint the cause, a comprehensive series of diagnostic evaluations was conducted:

• Blood tests: Revealed moderate anemia and critically low levels of vitamin B12
• Stool and urine analysis: No signs of infection or metabolic abnormalities
• Liver and kidney function: Mild impairment likely due to long-term alcohol exposure
• Brain and spinal MRI: Showed abnormal signal changes in the upper thoracic spinal cord, consistent with demyelination—a hallmark of subacute combined degeneration

The MRI findings, combined with biochemical evidence of B12 deficiency, confirmed the diagnosis. Chronic alcohol use had impaired nutrient absorption, particularly of B12 and folate, leading to irreversible nerve damage if left untreated. The good news? Early detection offered a window for meaningful recovery.

Comprehensive Treatment Strategy

Medical Intervention and Nutritional Support

The treatment plan focused on three pillars: correcting the deficiency, repairing neurological function, and eliminating contributing lifestyle factors. The patient received:

• Intramuscular vitamin B12 injections (high-dose) for rapid repletion
• Transitioned to oral vitamin B12 supplements for maintenance
• Folic acid tablets to support red blood cell production
• Polysaccharide-iron complex capsules to treat iron-deficiency anemia

Nutritional counseling emphasized a balanced diet rich in green leafy vegetables, lean proteins, and whole grains—foods naturally high in B vitamins and essential minerals.

The Critical Role of Alcohol Cessation

Perhaps the most transformative aspect of treatment was the decision to quit alcohol entirely. Alcohol interferes with B12 absorption, damages the gastrointestinal lining, and directly harms neurons. Continued drinking would have undermined all medical efforts. Through education and family involvement, the patient committed to sobriety—an essential step toward healing.

Progress and Recovery Timeline

Within the first week of treatment, noticeable improvements emerged. The patient reported reduced dizziness and better control during walking. By the second week, he could walk in a straight line without assistance, and coordination tests turned negative.

After 14 days of inpatient care, his condition had stabilized sufficiently for discharge. He was advised to return for follow-up one month later to monitor vitamin levels and assess ongoing progress. His ability to regain independence so quickly underscored the importance of early diagnosis and aggressive therapy.

Post-Discharge Guidance for Long-Term Wellness

Sustainable Lifestyle Changes

Recovery doesn't end at discharge. To prevent relapse and ensure lasting neurological health, the following recommendations were provided:

• Maintain total abstinence from alcohol—family members were encouraged to provide support and accountability
• Eat a nutrient-dense diet emphasizing dark leafy greens, eggs, dairy, and fortified cereals
• Avoid spicy, greasy, or heavily processed foods that may irritate the digestive system
• Continue taking prescribed supplements, especially B12, which may be required lifelong depending on absorption capacity
• Schedule regular bloodwork to monitor B12, folate, and iron levels

Patients with a history of alcohol-related deficiencies should consider periodic neurological assessments to catch any subtle changes early.

Clinical Insights and Broader Implications

Why This Case Matters

This case highlights a crucial yet often overlooked connection between chronic alcohol use and neurological deterioration. While many associate alcohol abuse with liver disease or addiction, its impact on the nervous system can be just as devastating. Conditions like SCD are reversible only when caught early—and treatment hinges not just on medication, but on behavioral change.

Moreover, symptoms like unsteady gait or poor coordination in older adults should never be automatically attributed to aging or intoxication. They may signal serious conditions including:

• Cerebellar infarction
• Spinal cord compression or degeneration
• Peripheral neuropathy from diabetes or toxins
• Vitamin deficiencies (especially B1, B6, B12, E)

Early referral to a neurologist and prompt imaging can make the difference between full recovery and permanent disability.

Final Thoughts: A Second Chance Through Awareness

This patient's story is one of hope and transformation. With appropriate medical care and the courage to confront a lifelong habit, he regained his mobility and quality of life. It serves as a powerful reminder that no matter a person's age or history, positive change is always possible.

If you or someone you love struggles with heavy drinking—or experiences unexplained balance issues—it's vital to seek professional help. Neurological damage may be silent at first, but once symptoms appear, time becomes critical. Through awareness, early testing, and lifestyle modification, conditions like subacute combined degeneration can be managed effectively, allowing individuals to live fuller, healthier lives.