Step 1: Tocopherol, the active form of vitamin E, is the principal fat-soluble antioxidant that shields membrane lipids from free-radical attack. Nervous tissue is heavily dependent on this protection.
Step 2: A shortfall of vitamin E therefore damages long sensory and cerebellar tracts, and the clinical hallmark is a progressive ataxia along with impaired proprioception and absent reflexes. This makes ataxia the correct option.
Step 3: Because the vitamin is plentiful in everyday foods such as cooking oils and green vegetables, true deficiency is rare and is usually tied to states that block fat absorption, including chronic pancreatic disease.
Step 4: The remaining choices do not fit. Strokes and heart failure are unrelated to this vitamin, and a megaloblastic blood picture points to B12 or folate lack instead.
\[\boxed{\text{Ataxia}}\]