Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Mini Review
  • Published:

Peroneal mononeuropathy and polyneuropathy in adolescents with Anorexia Nervosa: a case report and literature review

Abstract

Peroneal neuropathy and polyneuropathy are displayed with a variable percentage in subjects affected by eating disorders and in particular by anorexia nervosa. Actually, little is known on features of these complications during the paediatric age. We describe the case of a female adolescent with right peroneal palsy and subclinical polyneuropathy associated with anorexia nervosa (AN). We review previous research about peroneal mononeuropathy and polyneuropathy associated with AN, and we develop a diagnostic and therapeutic protocol to help clinicians recognize and treat these disorders.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The data supporting the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

References

  1. MacKenzie JR, LaBan MM, Sackeyfio AH. The prevalence of peripheral neuropathy in patients with anorexia nervosa. Arch Phys Med Rehabil. 1989;70:827–30.

    CAS  PubMed  Google Scholar 

  2. Patchell RA, Fellows HA, Humphries LL. Neurologic complications of anorexia nervosa. Acta Neurol Scand. 1994;89:111–6.

    Article  CAS  PubMed  Google Scholar 

  3. Gwathmey KG, Grogan J. Nutritional neuropathies. Muscle Nerve. 2020;62:13–29.

    Article  PubMed  Google Scholar 

  4. Shahar E, Landau E, Genizi J. Adolescence peroneal neuropathy associated with rapid marked weight reduction: case report and literature review. Eur J Paediatr Neurol. 2007;11:50–4.

    Article  PubMed  Google Scholar 

  5. Meylaerts L, Cardinaels E, Vandevenne J, Velghe B, Gelin G, Vanormelingen L, et al. Peroneal neuropathy after weight loss: a high-resolution ultrasonographic characterization of the common peroneal nerve. Skelet Radio. 2011;40:1557–62.

    Article  Google Scholar 

  6. Schott GD. Anorexia nervosa presenting as foot drop. Postgrad Med J. 1979;55:58–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Sotaniemi KA. Slimmer’s paralysis - peroneal neuropathy during weight reduction. J Neurol Neurosurg Psychiatry. 1984;47:564–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Hamel J, Logigian EL. Acute nutritional axonal neuropathy. Muscle Nerve. 2018;57:33–9.

    Article  PubMed  Google Scholar 

  9. Sotaniemi K, Kaarela K. Dry beriberi in a slimmer. Br Med J. 1977;2:1634–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Alloway R, Reynolds EH, Spargo E, Russell GFM. Neuropathy and myopathy in two patients with anorexia and bulimia nervosa. J Neurol Neurosurg Psychiatry. 1985;48:1015–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Renthal W, Marin-Valencia I, Evans PA. Thiamine deficiency secondary to anorexia nervosa: an uncommon cause of peripheral neuropathy and wernicke encephalopathy in adolescence. Pediatr Neurol. 2014;51:100–3.

    Article  PubMed  Google Scholar 

  12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Rethlefsen ML, Kirtley S, Waffenschmidt S, Ayala AP, Moher D, Page MJ, et al. PRISMA-S: an extension to the prisma statement for reporting literature searches in systematic reviews. Syst Rev. 2021;10:39.

    Article  PubMed  PubMed Central  Google Scholar 

  14. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th Edition). American Journal of Psychiatry. 2013.

  15. Jones HR, Felice KJ, Gross PT. Pediatric peroneal mononeuropathy: A clinical and electromyographic study. Muscle Nerve. 1993;16:1167–73.

    Article  PubMed  Google Scholar 

  16. Philip H. Neuropathy due to hypovitaminosis following excessive weight loss. J Am Acad Child Adolesc Psychiatry. 2004;43:925–6.

    Google Scholar 

  17. Steel JM, Lloyd GG, Young RJ, Clarke BF. Clinically apparent eating disorders in young diabetic women: Associations with painful neuropathy and other complications. Br Med J (Clin Res Ed). 1987;294:859–62.

    Article  CAS  PubMed  Google Scholar 

  18. Cruz-Martinez A, Arpa J, Palau F. Peroneal neuropathy after weight loss. J Peripher Nerv Syst. 2000;5:101–5.

    Article  CAS  PubMed  Google Scholar 

  19. Lau KHV, David WS, Sadjadi R. Clinical reasoning: a 15-year-old boy with bilateral wrist pain in the setting of weight loss. Neurology. 2019;92:486–92.

    Article  PubMed  Google Scholar 

  20. Marikar D, Reynolds S, Moghraby OS. Junior MARSIPAN (management of really sick patients with anorexia nervosa). Arch Dis Child - Educ Pr. 2016;101:140–3.

    Article  Google Scholar 

  21. Robinson P, Rhys Jones W. MARSIPAN: management of really sick patients with anorexia nervosa. BJPsych Adv. 2018;24:20–32.

    Article  Google Scholar 

  22. Rock CL, Curran‐Celentano J. Nutritional disorder of anorexia nervosa: a review. Int J Eat Disord. 1994;15:187–203.

    Article  CAS  PubMed  Google Scholar 

  23. Franques J, Chiche L, Mathis S. Sensory neuronopathy revealing severe vitamin B12 deficiency in a patient with anorexia nervosa: An often‐forgotten reversible cause. Nutrients. 2017;9:281.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Winston AP, Jamieson CP, Madira W, Gatward NM, Palmer RL. Prevalence of thiamin deficiency in anorexia nervosa. Int J Eat Disord. 2000;28:451–4.

    Article  CAS  PubMed  Google Scholar 

  25. Rock CL, Vasantharajan S. Vitamin status of eating disorder patients: relationship to clinical indices and effect of treatment. Int J Eat Disord. 1995;18:257–62.

    Article  CAS  PubMed  Google Scholar 

  26. https://sinu.it/. Società italiana di nutrizione umana.

Download references

Acknowledgements

Many thanks to Erika Trabattoni, Translator and Interpreter for supporting us in final editing of the manuscript.

Author information

Authors and Affiliations

Authors

Contributions

SM and AR study conception and design, GA data collection, SM, AR, CP and RN analysis and interpretation of results, and SM and AR manuscript preparation.

Corresponding author

Correspondence to A. Riva.

Ethics declarations

Competing interests

The authors declare no competing interests.

Patient and parent consent statement

Written informed consent for the publication of the case was obtained from the parents and patient.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Minghetti, S., Riva, A., Arienti, G. et al. Peroneal mononeuropathy and polyneuropathy in adolescents with Anorexia Nervosa: a case report and literature review. Eur J Clin Nutr 78, 280–285 (2024). https://doi.org/10.1038/s41430-024-01402-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-024-01402-2

Search

Quick links