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II. Vitamin Deficiencies

A. General Concepts
Malnutrition in general impairs both the developing and developed nervous system. A number of vitamin deficiency states, especially B vitamins, cause specific nervous system pathology. Examples of B1 and B12 deficiency states are described below. The B1 (thiamine) deficiency conditions are often associated with alcoholism and may be complicated by general malnutrition, but are ameliorated or reversed by B1.

B. Thiamine (vitamin B1) Deficiency

1. Alcoholic Polyneuropathy

a. Clinical Signs:  numbness, paresthesias, weakness; distribution depends on the specific nerves involved; both motor and sensory nerves affected, distal regions affected first

b. Pathology:  degeneration of both myelin and axons with axonal reaction in anterior horn cells; posterior root degeneration with secondary degeneration of posterior columns