Thiamine deficiency: a cause of childhood ataxia not to be ignored

We report four cases of childhood ataxia with and without encephalopathies which were successfully managed with thiamine supplementation and diagnosed in retrospect as being caused by thiamine deficiency. The clinical presentations were similar to those previously reported amongst adolescents and adults who ingested the larvae of Anaphe venata, a local delicacy among the Ijeshas of south-western Nigeria, during the rainy season. This has been called seasonal ataxia syndrome. The cases were of interest because the disorder was not described in children in the previous report, which might indicate a worsening nutritional status in these communities. This report is to alert child health physicians in the developing world to the possibility of a pre-existing thiamine deficiency progressing into ataxic disorders when certain foods are ingested.