NUTRITIONAL NERVE DISEASES
Deficiencies of some vitamins may produce neurological disturbances. These mainly belong to the B-complex group. These are as follows:
Vitamin B, or Aneurine or Thiamine deficiency
(a) Beriberi (see before).
(b) Neuropathy (See before).
(c) Wernicke’s encephalopathy.
This is due to congestion and haemorrhage of the hypothalamus and grey matter of the upper part of the brain stem particularly involving corpora mammillaria. The onset is insidious. There may be vomiting, nystagmus, confusion, disorientation of time and space, Korsakow’s syndrome and sleep disturbances. Gradually coma develops. Ophthalmoplegia, cerebellar ataxia, pupillary changes, polyneuropathy and bilateral extensor plantar reflexes may be present.
Vitamin B6 or Pyridoxine deficiency
(i) Infantile convulsion.
(ii) Polyneuritis particularly after INH therapy.
Vitamin B7 or Nicotinic acid or Niacin deficiency
Mania, melancholia, dementia, tremor, ataxia, neuritis, ophthalmoplegia, etc. may be seen as a part of clinical manifestation of Pellagra (see pellagra).
Pantothenic acid deficiency
Burning feet syndrome (Gopalan’s syndrome) characterized by severe burning sensation usually in both feet but no sign is present.
Vitamin B12 (Cyanocobalamin) deficiency
This may give rise to subacute combined degeneration of the spinal cord.
Appropriate Vitamins are to be given.