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Significant cerebrospinal fluid (CSF) acidosis was evident in 80 chronic alcoholics (mean pH, 7.25 +/- 0.06) who were compared with 14 neurologic controls (mean pH, 7.31 +/- 0.02). Acidosis persisted for many weeks after the last drink, and there was no associated systemic acidosis. CSF pH correlated significantly with CSF anion gap, suggesting a primary cerebral metabolic abnormality. Even though one-quarter of the alcoholic patients had a CSF pH less than 7.21, mental impairment was less than expected for the degree of CSF acidosis noted.
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