Abstract Details

Title Pyridoxine Deficiency in Patients with Peripheral Neuropathy Symptoms. A Case Series

Topic Peripheral Nerve

Presentation(s) P01 - (-)

Poster/Presentation
Number 137

Objective

Background BACKGROUND: Vitamin B6 deficiency has been associated with peripheral neuropathy. However, in the published literature there are not enough reports about the clinical characteristics of peripheral neuropathy in patients with B6 deficiency.

Design/Methods DESIGN/METHODS: We included patients seen from July 2011 to July 2012 in the Neurology clinic at University Of Missouri Hospital for 1) complaints of pain, numbness, tingling sensation in upper and/or lower limbs; 2) findings of decreased sensation to vibration, pinprick and/or propioception; 3) EMG/NCS or skin biopsy diagnostic of peripheral neuropathy and 4) low pyridoxine levels. We divided them into 2 groups: Group 1 with only low vitamin B6 and group 2 with vitamin B6 deficiency and other known causes of peripheral neuropathy.

Results RESULTS: A total of 40 patients were identified. Twelve patients were included in group 1 and 28 patients in group 2. When compared, group 1 patients had less frequency of decreased/absent distal propioception in physical exam (0%; in 2 patients propioception was not mentioned) versus group 2 (12 patients; 42.9%). Group 1 also had less frequency of associated distal weakness (1 patient; 8.3%) versus group 2 (8 patients; 28.6%). There was no difference in pinprick, vibration, reflexes, BMI values or proportion of overweight/obese patients between both groups.

Conclusions CONCLUSIONS: Low pyridoxine levels can be present in patients with peripheral neuropathy irrespective of nutritional status especially in patients with sensory symptoms without weakness and with normal propioception. The presence of other known causes of neuropathy should not preclude B6 level measurement as deficiency can be corrected. Frequent B6 monitoring is needed to avoid overdose. The impact of B6 supplementation on patients symptoms was not adressed in this series. The cause of low pyridoxine level in patients without apparent malnutrition deserves further investigation.

Authors/Disclosures
Miguel Chuquilin Arista, MD, FAAN PRESENTER	Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Item writer with ��ɫ��. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Item Writer with ��ɫ��. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Item Writer with ��ɫ��. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Item reviewer with National Board of Medical Examiners. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Southeast regional advisory board with Argenx. Dr. Chuquilin Arista has received personal compensation in the range of $500-$4,999 for serving as a Focus group with Alexion. Dr. Chuquilin Arista has received personal compensation in the range of $0-$499 for serving as a Speaker with Periodic Paralysis Association.
Tomas Kalincik	Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving as a Consultant for National Health and Medical Research Council. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MS Research Australia. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for WebMD Global. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for BioCSL. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eisai. The institution of Tomas Kalincik has received research support from Biogen. The institution of Tomas Kalincik has received research support from Novartis. The institution of Tomas Kalincik has received research support from Genzyme. The institution of Tomas Kalincik has received research support from Roche. The institution of Tomas Kalincik has received research support from Celgene. The institution of Tomas Kalincik has received research support from Merck. The institution of Tomas Kalincik has received research support from MSBase Foundation. The institution of Tomas Kalincik has received research support from ARSEP and EDMUS Foundations. The institution of Tomas Kalincik has received research support from MS Research Australia. The institution of Tomas Kalincik has received research support from National Health and Medical Research Council. The institution of Tomas Kalincik has received research support from Australian Research Council. The institution of Tomas Kalincik has received research support from MS Society. The institution of Tomas Kalincik has received research support from Trish Foundation. Tomas Kalincik has a non-compensated relationship as a scientific leadership group chair with MSBase Foundation that is relevant to AAN interests or activities.
	No disclosure on file
Leslie M. Shaw, PhD (Perelman School of Med, U of PA)	Dr. Shaw has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Shaw has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Shaw has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Shaw has received research support from NIA. The institution of Dr. Shaw has received research support from MJ Fox foundation for Parkinsons Research.

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