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Polyneuropathy and Folate Deficiency

Polyneuropathy and Folate Deficiency Abstract • We studied five patients (two men and three women, aged between 58 and 76 years) with clinical and electrophysiological signs of polyneuropathy. Routine neurological, hematological, and gastroenterological studies as well as procedures to test fat malabsorption were performed. Folate determinations were done using both radioactive and Lacto-bacillus casei methods. Two patients displayed the signs of subacute combined degeneration of the spinal cord with polyneuropathy, while three had only signs of neuropathy. All had low serum folate concentration, long-standing gastrointestinal disease, and deficient folate intake. The D-xylose absorption test gave low values in all patients, while none displayed the classical malabsorption syndrome. The patients had substantial improvement or recovered (according to clinical and electrophysiological measurements) after periods ranging from 9 to 39 months of folate therapy. Such acquired folate-responsive polyneuropathy has two principal characteristics: mixed sensorimotor with mainly sensory deficits, and involvement of one or both of the lower extremities much more extensively than the upper extremities. References 1. Folic acid and the nervous system , editorial. Lancet 2:836, 1976. 2. Folate deficiency and the nervous system , editorial. Br Med J 2:71, 1976. 3. Botez MI: Neuropsychiatric disorders, folate deficiency and jejunal atrophy . Ann R Coll Phys Surg 9:71-72, 1976. 4. Botez MI, Cadotte M, Beaulieu R, et al: Folic acid responsive neurological disorders . Can Med Assoc J 115:217-223, 1976. 5. Manzoor M, Runcie J: Folate responsive neuropathy: Report of ten cases . Br Med J 1:1176-1178, 1976.Crossref 6. Botez MI: Folate deficiency and neurological disorders in adults . Med Hypotheses 2:135-140, 1976.Crossref 7. Reynolds EH: Neurological aspects of folate and vitamin B12 metabolism . Clin Haematol 5:661-696, 1976. 8. Fehling C, Jagerstad M, Lindstrand K, et al: Folate deficiency and neurological disease . Arch Neurol 30:263-265, 1974.Crossref 9. Peyronnard JM, Lapointe L, Bouchard JP, et al: Nerve conduction studies and electromyography in Friedreich's ataxia . Can J Neurol Sci 3:313-317, 1976. 10. Botez MI, Fontaine F, Botez T, et al: Neuropsychological correlates of computerized transaxial tomography and radionuclide cisternography in folic acid deficiency: A report of 16 cases . Eur Neurol 16:230-246, 1977.Crossref 11. Cooke WT, Smith T: Neurological disorders associated with adult coeliac disease . Brain 89:683-722, 1966.Crossref 12. Iyer GW, Taori GM, Kapadia CR, et al: Neurologic manifestations in tropical sprue . Neurology 23:959-966, 1973.Crossref 13. Thomson AD, Frank O, De Angelis B, et al: Thiamine depletion induced by dietary folate deficiency in rats . Nutr Rep Int 6:107-110, 1972. 14. Fehling C, Jagerstad M, Lindstrand K, et al: Reduction of folate levels in the rat: Difference in depletion between the central and peripheral nervous system . Z Ernaehrungswiss 15:1-8, 1976.Crossref 15. Su CP: Congenital folate deficiency . N Engl J Med 294:1128, 1976. 16. Botez MI: Folate deficiency and neurological disease . Br Med J 2:699-700, 1976.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1978.00500330029005
Publisher site
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Abstract

Abstract • We studied five patients (two men and three women, aged between 58 and 76 years) with clinical and electrophysiological signs of polyneuropathy. Routine neurological, hematological, and gastroenterological studies as well as procedures to test fat malabsorption were performed. Folate determinations were done using both radioactive and Lacto-bacillus casei methods. Two patients displayed the signs of subacute combined degeneration of the spinal cord with polyneuropathy, while three had only signs of neuropathy. All had low serum folate concentration, long-standing gastrointestinal disease, and deficient folate intake. The D-xylose absorption test gave low values in all patients, while none displayed the classical malabsorption syndrome. The patients had substantial improvement or recovered (according to clinical and electrophysiological measurements) after periods ranging from 9 to 39 months of folate therapy. Such acquired folate-responsive polyneuropathy has two principal characteristics: mixed sensorimotor with mainly sensory deficits, and involvement of one or both of the lower extremities much more extensively than the upper extremities. References 1. Folic acid and the nervous system , editorial. Lancet 2:836, 1976. 2. Folate deficiency and the nervous system , editorial. Br Med J 2:71, 1976. 3. Botez MI: Neuropsychiatric disorders, folate deficiency and jejunal atrophy . Ann R Coll Phys Surg 9:71-72, 1976. 4. Botez MI, Cadotte M, Beaulieu R, et al: Folic acid responsive neurological disorders . Can Med Assoc J 115:217-223, 1976. 5. Manzoor M, Runcie J: Folate responsive neuropathy: Report of ten cases . Br Med J 1:1176-1178, 1976.Crossref 6. Botez MI: Folate deficiency and neurological disorders in adults . Med Hypotheses 2:135-140, 1976.Crossref 7. Reynolds EH: Neurological aspects of folate and vitamin B12 metabolism . Clin Haematol 5:661-696, 1976. 8. Fehling C, Jagerstad M, Lindstrand K, et al: Folate deficiency and neurological disease . Arch Neurol 30:263-265, 1974.Crossref 9. Peyronnard JM, Lapointe L, Bouchard JP, et al: Nerve conduction studies and electromyography in Friedreich's ataxia . Can J Neurol Sci 3:313-317, 1976. 10. Botez MI, Fontaine F, Botez T, et al: Neuropsychological correlates of computerized transaxial tomography and radionuclide cisternography in folic acid deficiency: A report of 16 cases . Eur Neurol 16:230-246, 1977.Crossref 11. Cooke WT, Smith T: Neurological disorders associated with adult coeliac disease . Brain 89:683-722, 1966.Crossref 12. Iyer GW, Taori GM, Kapadia CR, et al: Neurologic manifestations in tropical sprue . Neurology 23:959-966, 1973.Crossref 13. Thomson AD, Frank O, De Angelis B, et al: Thiamine depletion induced by dietary folate deficiency in rats . Nutr Rep Int 6:107-110, 1972. 14. Fehling C, Jagerstad M, Lindstrand K, et al: Reduction of folate levels in the rat: Difference in depletion between the central and peripheral nervous system . Z Ernaehrungswiss 15:1-8, 1976.Crossref 15. Su CP: Congenital folate deficiency . N Engl J Med 294:1128, 1976. 16. Botez MI: Folate deficiency and neurological disease . Br Med J 2:699-700, 1976.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Sep 1, 1978

References