Sensory neuropathy with low-dose pyridoxine

Area of Science:

• Neurology
• Toxicology
• Nutritional Science

Background:

• Pyridoxine (vitamin B6) is essential for neurological function.
• High-dose pyridoxine intake is increasingly recognized as a potential neurotoxin.
• Previous reports highlight the risk of neuropathy associated with vitamin B6 supplementation.

Purpose of the Study:

• To describe the clinical characteristics of neuropathy caused by pyridoxine abuse.
• To investigate the relationship between pyridoxine dosage, duration of intake, and symptom onset.
• To assess the reversibility of neuropathy upon pyridoxine discontinuation.

Main Methods:

• Case series describing 16 patients with neuropathy.
• Clinical examination and patient history to determine pyridoxine intake and symptoms.
• Follow-up assessments after pyridoxine cessation.

Main Results:

• All 16 patients presented with a consistent clinical picture of pure sensory central-peripheral distal axonopathy.
• Pyridoxine dosage ranged from 0.2 to 5 g/day.
• Symptom onset duration was inversely proportional to daily pyridoxine intake.
• All patients showed improvement after discontinuing pyridoxine.

Conclusions:

• Pyridoxine abuse can lead to a specific pattern of sensory neuropathy.
• The dose and duration of pyridoxine intake are critical factors in neurotoxicity.
• Discontinuation of pyridoxine is effective in reversing the neurological deficits.
• The widespread availability of high-dose pyridoxine tablets poses an ongoing risk for this condition.