Thiamine deficiency secondary to anorexia nervosa: An uncommon cause of peripheral neuropathy and wernicke encephalopathy in adolescence

William Renthal, Isaac Marin-Valencia, Patricia A. Evans

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

We present a developmentally appropriate adolescent boy who presented with upper and lower extremity glove-and-stocking paresthesias, distal weakness, vertigo, high-pitched voice, inattention, ataxia, and binocular diplopia after a voluntary 59-kg weight loss over 5 months. CLINICAL INVESTIGATIONS: Extensive investigations revealed serum thiamine levels <2 nmol/L. Brain magnetic resonance imaging revealed symmetric abnormal T2 prolongation of the mammillary bodies. Nerve conduction studies were consistent with axonal, length-dependent polyneuropathy. Together, these findings were diagnostic for peripheral polyneuropathy and Wernicke encephalopathy secondary to thiamine deficiency. CONCLUSION: This patient illustrates that eating disorders can be an uncommon cause of rapidly progressive paresthesias, weakness, and neurological decline due to thiamine deficiency.

Original languageEnglish (US)
Pages (from-to)100-103
Number of pages4
JournalPediatric Neurology
Volume51
Issue number1
DOIs
StatePublished - Jul 2014

Keywords

  • Wernicke encephalopathy
  • anorexia nervosa
  • dry beriberi
  • paresthesias
  • peripheral polyneuropathy
  • thiamine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology

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