ARBI is a term used to describe the physical impairment to the brain sustained as a result of alcohol consumption. Having ARBI is not the same as having an intellectual disability, nor is it the same as having dementia.

How much alcohol causes brain impairment

Alcohol has a toxic effect on the central nervous system and can result in changes to metabolism, heart functioning and blood supply. Alcohol can interfere with the absorption of thiamine (an important nutrient mediating brain functions) and is commonly associated with poor nutrition. Wastage of brain cells is often caused by dehydration, whilst falls and accidents associated with alcohol abuse may lead to brain impairment.

Disorders associated with ARBI

The degree of brain impairment resulting from alcohol consumption depends on many factors, including the amount and pattern of consumption, age, sex, nutrition and individual differences.

ARBI may be mild, moderate, severe or very severe. ARBI is associated with changes in cognition (memory and thinking abilities), difficulties with balance and coordination and a range of medical and neurological disorders.

The following description of common disorders related to ARBI aims to help workers become familiar with some of the medical terms encountered in the field.

Cerebellar Atrophy

Impairment to the part of the brain called the cerebellum causes balance and coordination difficulties, which typically affect the lower limbs and result in a wide-based gait (walking with the legs wide apart). Ataxia is the term used to describe the gait disorder.

Peripheral Neuropathy

Peripheral neuropathy is a sensory disturbance affecting the hands, feet and legs. It usually begins in the feet with numbness, pins and needles, burning sensations and pain, and may progress to loss of knee and ankle reflexes and muscle wasting.

Hepatic Encephalopathy

Hepatic encephalopathy is a neuropsychiatric syndrome seen in patients with liver disease. It can present with striking neurological and psychiatric changes and is characterised by acute exacerbations and remissions. The syndrome involves changes in sleep, mood and personality. Impairment and fluctuation of consciousness is accompanied by confusion, delirium and hallucinations and in the latter stages will progress to coma.

Frontal Lobe Dysfunction

Injury to the frontal lobes of the brain results in changes in thinking patterns, behaviour and personality. Frontal lobe dysfunction makes it difficult for people to plan and organise, to monitor and control behaviour, to think flexibly, and to adapt to change or unfamiliar situations.

Wernicke's Encephalopathy

Wernicke's encephalopathy is the acute neurological reaction to severe thiamine (Vitamin B1) deficiency and causes multiple disturbances of vision, ataxia and confusion. It may be reversed by administration of large doses of thiamine, but left untreated may progress to coma and death.

Korsakoff's Amnesic Syndrome

Korsakoff's amnesic syndrome is a profound impairment of short term memory that results in an almost complete inability to acquire any new information. An associated feature is confabulation, or tendency to fabricate missing memories. Korsafoffs amnesia is associated with multiple untreated episodes of Wernicke’s Encephalopathy.