A 15-year-old boy is evaluated for worsening gait instability, dysmetria, and dysarthria for the past several years. The patient stops play basketball due to his worsening symptoms. He is worried as his brother died of a neurologic disease at age 21. Physical examination of the lower extremities reveals bilateral motor weakness and loss of deep tendon reflexes, joint position, and vibration sense. MRI of the brain and spine shows degeneration of the posterior columns and spinocerebellar tracts. Which of the following conditions has clinical manifestations that closely resemble this patient's disease?

Question

A 15-year-old boy is evaluated for worsening gait instability, dysmetria, and dysarthria for the past several years.  The patient stops play basketball due to his worsening symptoms.  He is worried as his brother died of a neurologic disease at age 21.  Physical examination of the lower extremities reveals bilateral motor weakness and loss of deep tendon reflexes, joint position, and vibration sense.  MRI of the brain and spine shows degeneration of the posterior columns and spinocerebellar tracts.  Which of the following conditions has clinical manifestations that closely resemble this patient's disease?

Quizplus · Accepted Answer

Eductional Objective: Vitamin E is a lipid-soluble vitamin that has antioxidative properties.  Neurologic symptoms of vitamin E deficiency closely mimic Friedreich ataxia and include ataxia (due to degeneration of spinocerebellar tracts), loss of position and vibration sense (due to degeneration of the dorsal columns), and loss of deep tendon reflexes (due to peripheral nerve degeneration).

A 15-Year-Old Boy Is Evaluated for Worsening Gait Instability, Dysmetria