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.

Without treatment, patients are at risk for permanent neurologic damage such as spinocerebellar ataxia, peripheral neuropathy, impaired proprioception, absent reflexes, and, in advanced stages, vision loss from retinitis pigmentosa and macular degeneration.