Answer: Alcohol neuropathy
Explanation: The 45 year old man has a history of alcohol abuse and for him to sleep off on a bench instead if his bed might be due to the influence of the alcohol he took. Showing that he is still abusing alcohol.
Alcohol neuropathy is a peripheral nerve disorder that occurs in individuals with prolonged duration of alcohol abuse. The consumed alcohol is metabolised and excreted from the body. The metabolism of alcohol has a direct toxic effects on the neurons. An example of the peripheral nerve that can be affected in alcohol neuropathy is the radial nerve which innervates the arm, forearm, wrist and down to the tips of the finger. Therefore, the physical examination of the 45 year old man will reveal:
- decreased sensation over the first second and third digits and
- wrist drop.
Treatment should focus on stopping the alcohol abuse and nutritional replacement therapy. I hope this helps, thanks.