Vitamin E deficiency is a rare cause of ataxia, neuropathy, and retinopathy. Vitamin E is present in many oils, meats, eggs, leafy vegetables, and grains, so poor nutrition is not typically a cause of deficiency in developed countries. Since vitamin E is a fat-soluble vitamin, diseases that impair absorption of fat-soluble vitamins (eg, cystic fibrosis or pancreatic insufficiency, extensive small bowel resection) may cause deficiency. Abetalipoproteinemia can also cause a secondary vitamin E deficiency.
Onset of symptoms is typically gradual, with ataxia accompanied by impairment of dorsal column (vibratory / position) sensation and hyporeflexia.
Vitamin E deficiency is managed with treatment of the underlying cause and oral supplementation.