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NEUROLOGY 1987;37:1729
© 1987 American Academy of Neurology

Acute sensory neuropathy-neuronopathy from pyridoxine overdose

R. L. Albin, MD, J. W. Albers, MD, PhD, H. S. Greenberg, MD, J. B. Townsend, MD, R. B. Lynn, MD, J. M. Burke, Jr., MD and A. G. Alessi, MD

Departments of Neurology and Internal Medicine, The University of Michigan Medical Center, Ann Arbor, MI.

We report two patients who developed an acute, profound, and permanent sensory deficit after treatment with massive doses of parenteral pyridoxine. Aside from rapid onset, their clinical picture resembles that described in chronic pyridoxine neurotoxicity. It also is consonant with experimental models of acute pyridoxine intoxication and is probably secondary to a sensory ganglion neuronopathy. These patients also had transient autonomic dysfunction, mild weakness, nystagmus, lethargy, and respiratory depression. These previously undocumented features may be attributable to either the preservative used in the parenteral pyridoxine preparation or to the exceptionally high doses of pyridoxine these patients received.

Address correspondence and reprint requesta to Dr. Albers, The University of Michigan Medical Center, 1C325/0032 University Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0032.

Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.

Received December 15, 1986. Accepted for publication in final form February 12, 1987.




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