Orofacial sensory neuropathy associated with hypervitaminosis B6 caused by prolonged self-medication: A case report

Introduction : Self-medication with vitamin supplements carries underestimated toxicity risks. Excessive or prolonged vitamin B6 intake is known to induce sensory neuropathy, typically affecting the distal limbs. Observation : We report a 33-year-old woman with no relevant medical history who developed orofacial sensory neuropathy after seven weeks of daily intake of a multivitamin supplement containing 8.2 mg of vitamin B6 (Berocca®). She presented with paresthesia (numbness and tingling) localized to the right cheek and perioral region, with no motor involvement. Oral, dental, and radiological examinations were unremarkable. Plasma vitamin B6 was markedly elevated at 286 nmol/L (normal: 51–183 nmol/L). Supplement discontinuation led to complete symptom resolution and normalization of vitamin B6 levels (99 nmol/L) within one month, without evidence of a coasting effect. Conclusion : This case highlights a rare orofacial manifestation of B6 neurotoxicity, potentially involving disrupted GABAergic neurotransmission and pain signaling pathways. The atypical localization may delay diagnosis. Systematic nutritional assessment is warranted in patients presenting with unexplained paresthesia, and the public should be better informed of the risks associated with unsupervised vitamin supplementation.