Hypovitaminosis E is well-recognized but rare. It is usually due to the malabsorption of vitamin E, e.g. cystic fibrosis or pancreatic failure. It manifests as dysfunction of the CNS, characteristically presenting with a tremor and ataxia. Tendon reflexes are often absent.
Clinically and radiologically it may be indistinguishable from the neurological sequelae of hypovitaminosis B12, i.e. subacute combined degeneration of the cord (SACD) 2.