Clinical Reasoning: A 12-year-old boy with ascending weakness

French, Kris F.; Candee, Meghan; Stahl, J; Giles, Lisa; Glasgow, Tiffany S.; Morita, Denise C.

doi:10.1212/wnl.0b013e3182872845

Cited by 1 publication

(6 citation statements)

References 9 publications

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“…Anorexia is a complex neuropsychiatric disorder with multifactorial components (sociocultural, epigenetic, and genetic) 172 . Our review shows that anorexia is associated with various phenotypes of TD, WE being the culminating neurological presentation associated with other reported minor neuropsychiatric symptoms 79–82,84 . The multiple mechanisms leading to TD in anorexia include malnutrition associated with poor intake, as well as laxative use and self‐induced vomiting in patients with purging behaviors.…”

Section: Discussionmentioning

confidence: 89%

“…A Japanese survey revealed 33 children with regular intake of soft drinks who developed dramatic TD (confirmed by whole blood TDP) 77 . Of these, TD was clinically expressed as classical WE in four cases, one resulted in death, and 12 had long‐term neurological sequelae of TD. C6 : PTD related to eating disorders (anorexia) (10%) 79–84 . PTD related to eating disorders consistently occurs during adolescence, based on case reports.…”

Section: Resultsmentioning

confidence: 99%

“… C6 : PTD related to eating disorders (anorexia) (10%). 79 , 80 , 81 , 82 , 83 , 84 PTD related to eating disorders consistently occurs during adolescence, based on case reports. Two large case series referring to TD‐related anorexia were retrieved.…”

Section: Resultsmentioning

confidence: 99%

“…Early minor manifestations of TD neuropathy are characterized in this review by symmetrical sensory‐motor impairments (such as muscle pain and weakness), 84 dysarthria, dysfunction or paralysis of the lower extremities, progressive (gait) ataxia with or without inaugural signs of encephalopathy, and decreased deep tendon reflex function of the extremities, affecting mainly the lower limbs. This can progressively lead to altered consciousness 80,82,84,108,122 …”

Section: Discussionmentioning

confidence: 99%

“…This can progressively lead to altered consciousness. 80,82,84,108,122 The diagnosis of unexplained severe neurological signs of encephalopathy can benefit from modern neuroimaging and/or response to thiamine administration or both. In this review, there is no report of pseudo-meningitic forms that usually occur around 6−12 months of age.…”

Section: To What Extent Can Higher Diagnostic Capacities In Hics Infl...mentioning

confidence: 99%

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Pediatric thiamine deficiency disorders in high‐income countries between 2000 and 2020: a clinical reappraisal

Rakotoambinina

Hiffler²,

Gomes

2021

Annals of the New York Academy of Sciences

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Often thought to be a nutritional issue limited to low-and middle-income countries (LMICs), pediatric thiamine deficiency (PTD) is perceived as being eradicated or anecdotal in high-income countries (HICs). In HICs, classic beriberi cases in breastfed infants by thiamine-deficient mothers living in disadvantaged socioeconomic conditions are thought to be rare. This study aims to assess PTD in HICs in the 21st century. Literature searches were conducted to identify case reports of PTD observed in HICs and published between 2000 and 2020. The analyzed variables were age, country, underlying conditions, clinical manifestations of PTD, and response to thiamine supplementation. One hundred and ten articles were identified, totaling 389 PTD cases that were classified into four age groups: neonates, infants, children, and adolescents. Eleven categories of PTD-predisposing factors were identified, including genetic causes, lifestyle (diabetes, obesity, and excessive consumption of sweetened beverages), eating disorders, cancer, gastrointestinal disorders/surgeries, critical illness, and artificial nutrition. TD-associated hyperlactatemia and Wernicke encephalopathy were the most frequent clinical manifestations. The circumstances surrounding PTD in HICs differ from classic PTD observed in LMICs and this study delineates its mutiple predisposing factors. Further studies are required to estimate its magnitude. Awareness is of utmost importance in clinical practice.

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Section: Discussionmentioning

confidence: 89%