Acute nutritional axonal neuropathy

Muscle Nerve. 2018 Jan;57(1):33-39. doi: 10.1002/mus.25702. Epub 2017 Jun 19.


Introduction: This study describes clinical, laboratory, and electrodiagnostic features of a severe acute axonal polyneuropathy common to patients with acute nutritional deficiency in the setting of alcoholism, bariatric surgery (BS), or anorexia.

Methods: Retrospective analysis of clinical, electrodiagnostic, and laboratory data of patients with acute axonal neuropathy.

Results: Thirteen patients were identified with a severe, painful, sensory or sensorimotor axonal polyneuropathy that developed over 2-12 weeks with sensory ataxia, areflexia, variable muscle weakness, poor nutritional status, and weight loss, often with prolonged vomiting and normal cerebrospinal fluid protein. Vitamin B6 was low in half and thiamine was low in all patients when obtained before supplementation. Patients improved with weight gain and vitamin supplementation, with motor greater than sensory recovery.

Discussion: We suggest that acute or subacute axonal neuropathy in patients with weight loss or vomiting associated with alcohol abuse, BS, or dietary deficiency is one syndrome, caused by micronutrient deficiencies. Muscle Nerve 57: 33-39, 2018.

Keywords: Guillain-Barre syndrome; alcohol; neuropathic pain; nutritional; peripheral neuropathy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Alcoholic Neuropathy / pathology
  • Anorexia / complications
  • Axons / pathology*
  • Bariatric Surgery / adverse effects
  • Dietary Supplements
  • Electromyography
  • Female
  • Humans
  • Middle Aged
  • Muscle Weakness / etiology
  • Muscle Weakness / pathology
  • Neural Conduction
  • Nutrition Disorders / drug therapy
  • Nutrition Disorders / etiology
  • Nutrition Disorders / pathology*
  • Nutritional Status
  • Polyneuropathies / drug therapy
  • Polyneuropathies / pathology*
  • Vitamin B 6 Deficiency / complications
  • Vitamin B 6 Deficiency / pathology
  • Vitamins / therapeutic use
  • Vomiting / complications
  • Weight Gain
  • Young Adult


  • Vitamins