Eissa Hesham, Elhassan Khalid, Alzaabi Amani, Abouelnaga Mohamed E, Elbashari Mahfoud
Neurology-Internal Medicine, Zayed Military Hospital, Abu Dhabi, ARE.
Cureus. 2025 Apr 3;17(4):e81648. doi: 10.7759/cureus.81648. eCollection 2025 Apr.
Thiamine (vitamin B1), a critical cofactor for carbohydrate metabolism and neurotransmitter synthesis, plays an indispensable role in neuro-ophthalmic health. Deficiency of this crucial nutrient, while traditionally associated with a range of neuro-ophthalmic symptoms, can often lead to clinical presentations that are far from typical. In this case series, we delve into the unique experiences of three young men who developed uncommon neuro-ophthalmic manifestations due to thiamine deficiency following rapid weight loss due to strenuous exercises. Involvement of the optic nerve, presenting as either optic neuritis or papilledema, stands as an unusual revelation of thiamine deficiency; the insidious nature of imaging abnormalities, which require time to manifest, poses an additional diagnostic challenge. It is crucial to recognize that factors such as rapid weight loss and strenuous exercise can precipitate thiamine deficiency, potentially hastening the onset of its neuro-ophthalmic manifestations. Prompt recognition and intervention are essential to mitigate the risk of permanent neurologic deficits, emphasizing the imperative need for awareness and vigilance among healthcare practitioners. Through this series, we aim to augment the understanding of this under-recognized clinical entity.
硫胺素（维生素B1）是碳水化合物代谢和神经递质合成的关键辅助因子，在神经眼科健康中发挥着不可或缺的作用。这种关键营养素的缺乏，虽然传统上与一系列神经眼科症状相关，但往往会导致远非典型的临床表现。在这个病例系列中，我们深入探讨了三名年轻男性的独特经历，他们因剧烈运动导致体重快速下降后出现硫胺素缺乏，进而出现了罕见的神经眼科表现。视神经受累，表现为视神经炎或视乳头水肿，是硫胺素缺乏的一种不寻常表现；成像异常具有隐匿性，需要时间才能显现，这带来了额外的诊断挑战。必须认识到，快速体重减轻和剧烈运动等因素会促使硫胺素缺乏，可能加速其神经眼科表现的出现。及时识别和干预对于降低永久性神经功能缺损的风险至关重要，这强调了医疗从业者提高认识和保持警惕的迫切需要。通过这个系列，我们旨在加深对这个未得到充分认识的临床实体的理解。
