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Case Report
A case report of monoplegia due to vitamin B1 deficiency
1 MD, PhD, Professor, Department of Neurology, Center for Integrative Medicine, Tsukuba University of Technology, Tsukuba, Japan
2 MD, PhD, Department of Orthopedic Surgery, Koga General Hospital, Japan
3 MD, PhD, Professor, Department of Neurosurgery, Center for Integrative Medicine, Tsukuba University of Technology, Tsukuba, Japan
4 MD, PhD, Professor, Department of Radiological Technology, Tsukuba International University, Tsukuba, Ibaraki, Japan
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Nobuko Shiraiwa
4-12-7 Kasuga, Tsukuba, Ibaraki 305-8521,
Japan
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Article ID: 100023N06NS2025
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Shiraiwa N, Iwanami A, Ayuzawa S, Ohkoshi N. A case report of monoplegia due to vitamin B1 deficiency. Edorium J Neurol 2025;10(2):7–10.ABSTRACT
Introduction: Thiamine (vitamin B1) is a water-soluble vitamin essential for cellular metabolism, specifically in the tricarboxylic acid cycle (Krebs’s cycle). Neuropathy due to thiamine deficiency is referred to as dry beriberi. Dry beriberi neuropathy is a metabolic disorder making significant left-right disparity or monoplegia relatively rare. Due to the presence of monoplegia, a relationship with vitamin deficiency may not have been considered, leading to delays in treatment. We investigated the clinical characteristics of a patient with monoplegia and vitamin B1 deficiency. The serum vitamin B1 concentration was 22 ng/mL, which is below the normal reference range of 24–66 ng/mL. The patient achieved complete recovery after approximately four months of vitamin B1 supplementation.
Case Report: A 53-year-old woman developed left leg weakness and difficulty walking following approximately three months of appetite loss and chronic alcohol use due to depression. She initially consulted an orthopedic surgeon, and pelvic magnetic resonance imaging (MRI) revealed swelling of the left sciatic nerve, and inflammation (or) ischemia was suspected. Laboratory testing showed a low level of serum vitamin B1. Nerve conduction studies demonstrated peroneal and tibial neuropathy on the left side. Although beriberi was initially considered unlikely due to the marked asymmetry between the left and right limbs, the patient’s left leg monoplegia improved immediately after the initiation of thiamine supplementation. She achieved full recovery after approximately four months of continuous treatment.
Conclusion: This study evaluated the clinical course of monoplegia caused by vitamin B1 deficiency. The patient was completely cured with thiamine supplementation. This finding suggests the need to consider the possibility of neuropathy due to vitamin deficiency even in patients with monoplegia. Routine vitamin B1 testing should be considered in similar clinical cases to facilitate early diagnosis and treatment.
Keywords: Beriberi, Monoplegia, Sciatic nerve, Thiamine supplementation therapy, Vitamin B1
SUPPORTING INFORMATION
Acknowledgments
We would like to thank Editage (www.editage.jp) for English language editing.
Author ContributionsNobuko Shiraiwa - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Akio Iwanami - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Satoshi Ayuzawa - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Norio Ohkoshi - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Nobuko Shiraiwa et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
