The most accurately described causes of alcohol-related myelopathy are cases of hepatic myelopathy, which is myelopathy in the setting of either liver cell failure or portosystemic failure resulting in toxic myelopathy in the absence of liver failure. One of the few descriptions of myelopathy completely attributed to toxic effects of alcohol or its metabolites alone is by Sage et al., who reported five patients with the condition who had no evidence of hepatic involvement, portal hypertension, or nutritional deficiency.
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