Two forms of muscular alterations have been described in alcoholic patients, one acute, the so called Hypokalemic alcoholic Myopathy; focal or diffuse pain, swelling, tenderness and weakness of skeletal muscle are the main clinical features, and the chronic one with proximal muscle weakness wich progresses slowly in a period of weeks or months Ultrastructurally myofibril disorganization and necrosis where described.

In this work we present a systematic study of skeletal muscle alterations in four alcoholic patients who attended the Department of Internal Medicine at Caracas University Hospital . The patients were males, ages between 56 and 62 years old, and presented chronic alcoholism with muscle weakness with a more distal distribution and polymyalgia. Biopsies were taken from quadriceps femorismuscle with a percutaneous neddle and processed for routine transmission electron microscopy.

Muscle fibers showed different degrees of atrophy with myofibril disorganization (Fig.l) and disappearence (Fig.2). Myonuclei were hyperchromatic and intermyofibrilar spaces were widened and exhibited abundant lipid droplets.