Neurologic and evoked potential abnormalities in subtle cobalamin deficiency states, including deficiency without anemia and with normal absorption of free cobalamin - PubMed (original) (raw)
Neurologic and evoked potential abnormalities in subtle cobalamin deficiency states, including deficiency without anemia and with normal absorption of free cobalamin
D S Karnaze et al. Arch Neurol. 1990 Sep.
Abstract
The meaning of a low serum cobalamin level when the classic findings of pernicious anemia are lacking is undergoing reevaluation. We therefore studied the neurologic status of 11 patients who had low cobalamin levels without definite hematologic evidence of deficiency. Neurologic evaluation included pattern-shift visual and median and posterior tibial nerve somatosensory evoked potentials. None of the patients had megaloblastic changes in the blood or bone marrow, although 7 of the 11 had subtle cellular cobalamin disturbances demonstrated by an abnormal deoxyuridine suppression test result. Seven patients had normal Schilling test results and 2 had borderline results; however, 2 of the 5 patients tested further had food-cobalamin malabsorption, while a third had prepernicious anemia. The patients displayed a variety of neurologic problems, including dementia, depression, myelopathy, neuropathy, and seizure disorder; 1 patient was neurologically normal by clinical criteria. Evoked potential abnormalities were demonstrable in 8 of the 9 patients with subtle cobalamin deficiency, and in at least 5 cases the disturbance was central. In contrast, both patients whose low serum cobalamin levels were found on evaluation to be spurious had normal evoked potentials. Evoked potential abnormalities improved in the one patient retested after cobalamin therapy. These findings demonstrate that neurologic deficits occur not only in classic cobalamin deficiency but also in subtle or atypical cobalamin deficiency states in which anemia is absent and Schilling test results are normal. Electrophysiologic evidence of neurologic impairment is often present, even in patients without obvious clinical neurologic abnormalities.
Similar articles
- The frequently low cobalamin levels in dementia usually signify treatable metabolic, neurologic and electrophysiologic abnormalities.
Carmel R, Gott PS, Waters CH, Cairo K, Green R, Bondareff W, DeGiorgio CM, Cummings JL, Jacobsen DW, Buckwalter G, et al. Carmel R, et al. Eur J Haematol. 1995 Apr;54(4):245-53. doi: 10.1111/j.1600-0609.1995.tb00679.x. Eur J Haematol. 1995. PMID: 7789470 - Subtle and atypical cobalamin deficiency states.
Carmel R. Carmel R. Am J Hematol. 1990 Jun;34(2):108-14. doi: 10.1002/ajh.2830340206. Am J Hematol. 1990. PMID: 2187334 Review. - The neurology of cobalamin.
Shevell MI, Rosenblatt DS. Shevell MI, et al. Can J Neurol Sci. 1992 Nov;19(4):472-86. Can J Neurol Sci. 1992. PMID: 1423045 Review.
Cited by
- Is vitamin B12 deficiency a risk factor for gastroparesis in patients with type 2 diabetes?
Ahmed SS, El-Hafez HAA, Mohsen M, El-Baiomy AA, Elkhamisy ET, El-Eshmawy MM. Ahmed SS, et al. Diabetol Metab Syndr. 2023 Mar 1;15(1):33. doi: 10.1186/s13098-023-01005-0. Diabetol Metab Syndr. 2023. PMID: 36855172 Free PMC article. - The Role of Methyl Donors of the Methionine Cycle in Gastrointestinal Infection and Inflammation.
Vaccaro JA, Naser SA. Vaccaro JA, et al. Healthcare (Basel). 2021 Dec 29;10(1):61. doi: 10.3390/healthcare10010061. Healthcare (Basel). 2021. PMID: 35052225 Free PMC article. Review. - Reversible cutaneous silent period abnormalities in vitamin B12 deficiency: A case report.
Fava E, Kofler M, Saltuari L. Fava E, et al. Clin Neurophysiol Pract. 2019 May 31;4:128-132. doi: 10.1016/j.cnp.2019.05.002. eCollection 2019. Clin Neurophysiol Pract. 2019. PMID: 31249907 Free PMC article. - Comparison of two modes of vitamin B12 supplementation on neuroconduction and cognitive function among older people living in Santiago, Chile: a cluster randomized controlled trial. a study protocol [ISRCTN 02694183].
Sánchez H, Albala C, Lera L, Castillo JL, Verdugo R, Lavados M, Hertrampf E, Brito A, Allen L, Uauy R. Sánchez H, et al. Nutr J. 2011 Sep 27;10:100. doi: 10.1186/1475-2891-10-100. Nutr J. 2011. PMID: 21952034 Free PMC article. Clinical Trial. - Assessment of the vitamin B12 status of pregnant women in Nigeria using plasma holotranscobalamin.
Vanderjagt DJ, Ujah IA, Ikeh EI, Bryant J, Pam V, Hilgart A, Crossey MJ, Glew RH. Vanderjagt DJ, et al. ISRN Obstet Gynecol. 2011;2011:365894. doi: 10.5402/2011/365894. Epub 2011 Jul 14. ISRN Obstet Gynecol. 2011. PMID: 21789284 Free PMC article.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical