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      Pyridoxine Toxicity Small Fiber Neuropathy With Dysautonomia: A Case Report.

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          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.

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          Author and article information

          Journal
          J Clin Neuromuscul Dis
          Journal of clinical neuromuscular disease
          Ovid Technologies (Wolters Kluwer Health)
          1537-1611
          1522-0443
          Sep 2017
          : 19
          : 1
          Affiliations
          [1 ] Department of Neurology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
          Article
          00131402-201709000-00008
          10.1097/CND.0000000000000172
          28827489
          54c18a24-376c-4743-b3f4-9d149a01b896
          History

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