Chapter

Neuropathies Associated with Vitamin and Essential Mineral Deficiencies and Malabsorption

Steven Herskovitz

in Peripheral Neuropathies in Clinical Practice

Published on behalf of Oxford University Press

Published in print November 2008 | ISBN: 9780195183269
Published online April 2013 | e-ISBN: 9780199322947 | DOI: http://dx.doi.org/10.1093/med/9780195183269.003.0011

Series: CONTEMP NEURO

Neuropathies Associated with Vitamin and Essential Mineral Deficiencies and Malabsorption

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Few vitamin and essential mineral deficiencies cause polyneuropathy, namely, vitamin B12 (cobalamin), vitamin B1 (thiamine), copper, and probably vitamin E (α-tocopherol). Celiac disease is an autoimmune disorder which may be associated with malabsorption symptoms and mimics a vitamin deficiency affecting the nervous system. Polyneuropathy in all these conditions is usually mild, distal, sensory, and axonal; associated central nervous system (CNS) features are common and often predominate. Ataxia is common to all of these disorders. Vitamin B12, vitamin E, and copper deficiencies are associated with myelopathic signs (Table 11–1). Vitamin B12 and thiamine deficiencies are associated with cognitive changes. The association of vitamin E deficiency and polyneuropathy is less certain in humans. It is based on a few case reports, the finding of low α-tocopherol in sural nerves of patients with vitamin E deficiency, and the finding of a myeloradiculoneuropathy in vitamin E–deficient rats and monkeys.1–5 Copper deficiency causes a myeloneuropathy mimicking subacute combined degeneration due to vitamin B12 deficiency without cognitive dysfunction.6,7 Bariatric surgery can cause vitamin and mineral deficiencies through malabsorption, compressive mononeuropathies, and inflammatory neuropathies.8,9 The Cuban epidemic optic and peripheral neuropathy is an axonopathy thought to be related to nutritional deficiencies and exposure to toxins such as tobacco.10–12

Chapter.  9644 words.  Illustrated.

Subjects: Neurology

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