Pyridoxine Toxicity Small Fiber Neuropathy with Dysautonomia: A Case Report

Rae Bacharach, Max Lowden, Aiesha Ahmed

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Pyridoxine (vitamin B6) toxicity is a well-known cause of primary sensory, length-dependent, axonal polyneuropathy. Although sensory symptoms predominate, autonomic symptoms have also been reported in some cases. To date, there is no objective evidence of autonomic dysfunction reported in the literature. We present the case of a 41-year-old woman with 2 years of progressive burning pain, numbness, tingling, and weakness in a stocking-glove distribution who was found to have severe pyridoxine toxicity. Concurrent presence of large and small fiber nerve dysfunction was noted in the form of abnormal electromyography/nerve conduction study demonstrating a chronic sensory polyneuropathy and autonomic testing demonstrating abnormal responses to quantitative sweat testing and cardiovagal function testing. This case highlights the need for consideration of small fiber nerve damage by obtaining autonomic testing in cases of pyridoxine toxicity.

Original languageEnglish (US)
Pages (from-to)43-46
Number of pages4
JournalJournal of Clinical Neuromuscular Disease
Volume19
Issue number1
DOIs
StatePublished - Sep 1 2017

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Primary Dysautonomias
Pyridoxine
Polyneuropathies
Nerve Fibers
Vitamin B 6
Hypesthesia
Sweat
Neural Conduction
Electromyography
Pain
Small Fiber Neuropathy

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

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Pyridoxine Toxicity Small Fiber Neuropathy with Dysautonomia : A Case Report. / Bacharach, Rae; Lowden, Max; Ahmed, Aiesha.

In: Journal of Clinical Neuromuscular Disease, Vol. 19, No. 1, 01.09.2017, p. 43-46.

Research output: Contribution to journalArticle

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