Polyneuropathy and folate deficiency
M. I. Botez, J. M. Peyronnard, J. Bachevalier and L. Charron
We studied five patients (two men and three women, age between 58 and 76
years) with clinical and electrophysiological signs of polyneuropathy.
Routine neurological, hematological, and gastroenterological studies as
well as procedures to test fat malabsorption were performed. Folate
determinations were done using both radioactive and Lactobacillus casei
methods. Two patients displayed the signs of subacute combined degeneration
of the spinal cord with polyneuropathy, while three had only signs of
neuropathy. All had low serum folate concentration, long-standing
gastrointestinal disease, and deficient folate intake. The D-xylose
absorption test gave values in all patients, while none displayed the
classical malabsorption syndrome. The patients had substantial improvement
or recovered (according to clinical and electrophysiological measurements)
after periods ranging from 9 to 39 months of folate therapy. Such acquired
folate-responsive polyneuropathy has two principal characteristics: mixed
sensorimotor with mainly sensory deficits, and involvement of one or both
of the lower extremities much more extensively than the upper extremities.
