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A difficult case
Strachan’s syndrome and riboflavin deficiency
  1. Caroline Kramarz1,
  2. James McHugh2,
  3. Alexander Rossor1,3
  1. 1 Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
  2. 2 Department of Ophthalmology, King's College Hospital, London, UK
  3. 3 Department of Neurology, Guys and St Thomas’ Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Alexander Rossor, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK; a.rossor{at}ucl.ac.uk

Abstract

Strachan’s syndrome comprises a triad of optic, auditory and painful sensory peripheral neuropathy. It has been recognised since the late 19th century and is presumed to result from nutritional deficiency. Patients present acute or subacutely after a period of systemic illness, weight loss or, most commonly, dietary restriction, especially veganism, which can cause riboflavin (vitamin B2) and vitamin B12 deficiencies. The syndrome is more common in people who are black British and often of Jamaican descent. We describe the clinical phenotype using a typical case example, review other endemic nutritional peripheral neuropathies and discuss the potential benefit of riboflavin as a treatment.

  • NEUROPATHOLOGY

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

https://doi.org/10.1136/pn-2023-003822

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    Data availability statement

    Data sharing not applicable as no datasets generated and/or analysed for this study.

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    Footnotes

    • Contributors CK wrote the first draft of the manuscript. CK and AR were involved in the design and conception of the paper. CK, JM and AR edited, critically revised and approved the final manuscript for submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests CK is supported by a UCL Queen Square Institute of Neurology and Cleveland Clinic London MPhil/PhD Neuroscience Fellowship. AR is supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre.

    • Provenance and peer review Commissioned. Externally reviewed by David Bennett, Oxford, UK.

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