Ataxia due to vitamin E deficiency: A case report and updated review

Abstract

Ataxia with vitamin E deficiency (AVED) is a rare cause of hereditary ataxia in developing countries with unknown prevalence. AVED is an autosomal-recessive disorder, which is characterized by ataxia, areflexia, and proprioceptive and vibratory sensory loss. The disease is characterized clinically by symptoms with often resembling to those of Friedreich ataxia (FRDA). Vitamin E supplementation improves symptoms and prevents the progression of the disease. In this case report, we reviewed the recently updated findings in AVED in regard to the management and present a case of AVED in a 16-year-old boy, who was initially misdiagnosed as FRDA, prior to the genetic test.

Delayed cerebellar ataxia induced by Plasmodium falciparum malaria: A rare complication

“…In this communication, we report a case of delayed cerebellar ataxia due to P. falciparum infection with the onset of slurred speech, bilateral tremors affecting both upper limbs, and an unsteady gait during walking. Cerebellar involvement of P. falciparum malaria can occur during the acute stage of fever, as a consequence of cerebral malaria, as a delayed cerebellar ataxia (DCA), or as a side effect of antimalarial therapy 16–21 . This case of DCA is induced by malaria infection has occurred in an area hyperendemic with malaria, namely Khartoum state in central Sudan.…”

“…Cerebellar ataxia can be caused by many conditions, including alcohol abuse, stroke, brain degeneration, multiple sclerosis, drugs, genetic and autoimmune diseases, as well as several infectious diseases, and even vitamin E deficiency 16,17 . Malaria is one of the leading causes for the development of CA 18–22 .…”

“…4,22 Cerebellar ataxia can be caused by many conditions, including alcohol abuse, stroke, brain degeneration, multiple sclerosis, drugs, genetic and autoimmune diseases, as well as several infectious diseases, and even vitamin E deficiency. 16,17 Malaria is one of the leading causes for the development of CA. [18][19][20][21][22] Malaria in humans is commonly caused by one of five species of plasmodium, and P. falciparum species causes the majority of malaria infections in Africa including Sudan and it is particularly associated with the development of neurological complications.…”

“…Cerebellar involvement of P. falciparum malaria can occur during the acute stage of fever, as a consequence of cerebral malaria, as a delayed cerebellar ataxia (DCA), or as a side effect of antimalarial therapy. 16 , 17 , 18 , 19 , 20 , 21 This case of DCA is induced by malaria infection has occurred in an area hyperendemic with malaria, namely Khartoum state in central Sudan. The development of DCA in this case could be mainly attributed to the lack of detecting and treating the malaria infection during the initial presentation of the patient at the outpatient clinic.…”

A patient with neuropathy and ataxia: what do I have to consider?

“…The primary imaging abnormality is a decrease of the antero-posterior diameter of the medulla oblongata and the cervical spinal cord, consistent with degeneration of the ascending posterior columns [56]. In AVED, cerebellar atrophy is usually absent [57], although mild hemispheric atrophy may occasionally be visualized. In contrast to FA, no cervical spine abnormalities are seen [58].…”