Acute Stereotypic Behavior: Expanding the Spectrum of Movement Disorders Attributed to Vitamin B12 Deficiency (original) (raw)
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Unusual neurological presentations of vitamin B12 deficiency
European Journal of Neurology, 2004
Vitamin B12 deficiency (B12D) has a wide variety of neurological symptoms and signs. However, cerebellar dysfunction and cranial neuropathies other than optic neuropathy have been rarely reported. Herein, we describe two cases of unusual neurological manifestations of B12D. One patient showed prominent hoarseness with vocal cord paralysis, myelopathy, and peripheral neuropathy. The other had gait disturbance, lateral gaze limitation and cerebellar dysfunction in addition to the typical manifestations of subacute combined degeneration. Vitamin B12 deficiency can rarely affect cerebellum and cranial nerves other than optic nerve.
Neurological Manifestations of Vitamin B12 Deficiency: Study of a Series of 43 Cases
Background: Vitamin B12 deficiency can affect the nervous system, with various neurological manifestations causing diagnostic difficulties, especially when the blood count and vitamin B12 dosage are normal. Materials and Methods: We propose to analyze the epidemiological, clinical, para-clinical and evolutional profiles of 43 patients with neurological manifestations due to vitamin B12 deficiency, hospitalized at the department of neurology of Bab El Oued University Hospital Algiers.
African Health Sciences, 2013
Background: Vitamin B12 deficiency is associated with a wide spectrum of neuro-psychiatric manifestations. Results: We report a case of a 44 year old female patient referred to the haematology unit with vitamin B12 deficiency presenting as an acute confusional state or delirium. Total resolution of the psychiatric symptoms occurred following parenteral vitamin B12 replacement therapy. Conclusion: This case report highlights one of the neuro-psychiatric presentations of vitamin B12 deficiency in a previously healthy individual.
Reversible Vitamin B12 Deficiency Presenting with Acute Dementia, Paraparesis, and Normal Hemoglobin
Case Reports in Neurological Medicine, 2016
Vitamin B12 is essential for neurological function and its deficiency is associated with many neuropsychiatric disorders. We report the case of a previously healthy 53-year-old male patient presenting with delirium and multiple neurological findings. Complete blood analysis indicated megaloblastic anemia. All infectious causes were excluded owing to negative cultures (blood and urine). Tests for human immunodeficiency virus, syphilis, and toxoplasma were also negative. Metabolic workup showed severe vitamin B12 deficiency, decreased reticulocyte count, and increased direct bilirubin and lactate dehydrogenase. Intramuscular injection of cobalamin was started, and the patient showed significant improvement.
Vitamin B12 Deficiency; Frequency of Neurological Manifestations in Quetta
THE PROFESSIONAL MEDICAL JOURNAL, 2017
To determine the frequency of neurological manifestations of vitamin B 12 deficiency and to observe the reversibility of the symptoms after the therapy. Study Design: Descriptive study. Study Design: Descriptive study. Setting: Medicine Department of Bolan Medical Complex Hospital Quetta. Period: One year that is from January 2012 to December 2012. Methodology: 46 patients presented to various OPDS of B.M.C.H.. The inclusion criteria for the patients to be studied were: Anemia, Neurological complaints. Results: Out of 46 patients 26(56%) were males and 20(43%) were the females with a mean age of (40) years.32 (69%) belonged to the rural areas. 45(97%) had mixed diets whereas only one 1(2.1%) young non Muslim was found to be pure vegetarian.32 (69%) patients presented with hematological as well as neurological complaints. 23(30%) had pancytopenia and 9(19.5%) had bicytopenia. 14(30%) presented with neurological complaints only as sacd 6 (13%), ataxia 8 (17%), sensorimotor neuropathies 36 (78%) and dementia 2 (4.3%). In signs glossitis was found in 6(13%), jaundice in 22 (47%), pallor in 32 (69%) proximal myopathy in 12 (26%) out of which 6 (13%) had shoulder girdle and 8 (17%) pelvic girdle myopathy. Impaired position sense was found in 18 (39%) patients and vibration sense in 21(45%) patients. other signs were pigmentation 2(4.3%) hypotonia in 6(13%) Spasticity in 2(4.3%) and Upgoing plantars in 6(13%) patients. Lhermittes sign could be elicited in only 2(4.3%) patients Optic neuritis and optic atrophy was found in 4(8.6%) patients who came with paraplegia and marked anemia. Rhombergs sign was positive in 8(17.3%) who came with clumsiness of gait. Hemoglobin (Hb %) was found to be low in 32(69%) with a mean of 7.2gm%.pancytopenia (anemia+leucopenia+thrombocytopenia) was found in 23(50%) of patients whereas bicytopenia was found only in 9(19.5%) of patients. Hypersegmented W.B.C were very carefully looked for and were found in 20(43%) of cases. ovalomegaloblasts were found in 32 (69%) of cases .both findings of ovalomegaloblasts and hypersegmented w.b.cs were found in 20 (43%). in the rest 14 (30%) the blood investigations were found to be normal. The next investigation in all patients was serum B 12 estimation, It was found that levels below 200pg/ml were found in 95% cases where only 2(4.3%) patients came with levels slightly above 205pg/ml and 210pg/ml. the response to therapy was recorded as reversible and irreversible. the irreversible features were sacd in 6 (13%), optic atrophy in 2 (4.3%), and dementia in 2 (4.3%) patients. the partially reversible features were myelopathy 10 (21%) numbness and paraesthesias 30 (65%) optic neuritis inn 2 (4.3%) patients were assessed on a duration of 24 weeks. partially reversible features were ataxia, in 6 (13%) patients myelopathy in 2 (4.3%) patients dementia in 2 (4.3%) patients and paraesthesias and numbness in 6 (13%) patients over a period of 24 weeks. Conclusion: It is concluded from my study that the neuropsychiatric manifestations of vitamin B 12 deficiency are common among the elderly age group, either with or with out the evidence of anemia.
B12 deficiency with neurological manifestations in the absence of anaemia
BMC Research Notes, 2015
Background: Vitamin B 12 deficiency is often diagnosed with hematological manifestations of megaloblastic macrocytic anemia, which is usually the initial presentation. Neurological symptoms are often considered to be late manifestations and usually occur after the onset of anemia. Sub acute combined cord degeneration, which is a rare cause of myelopathy is however the commonest neurological manifestation of vitamin B 12 deficiency. Case presentation: We present a case of a 66 year old Sinhalese Sri Lankan female, who is a strict vegetarian, presenting with one month's history suggestive of Sub-acute combined cord degeneration in the absence of haematological manifestations of anaemia. Her Serum B 12 levels were significantly low, after which she was treated with hydroxycobalamine supplementation, showing marked clinical improvement of symptoms, with normalization of serum B 12 levels. Hence, the diagnosis of vitamin B 12 deficiency was confirmed retrospectively. Conclusion: Vitamin B 12 deficiency could rarely present with neurological manifestations in the absence of anaemia. Therefore a high index of suspicion is necessary for the early diagnosis and prompt treatment in order to reverse neurological manifestations, as the response to treatment is inversely proportionate to the severity and duration of the disease.
Neuropsychiatric Disorders Associated With Vitamin B12 Deficiency: An Autobiographical Case Report
Cureus, 2022
Vitamin B12 is an essential vitamin. Among its many functions is its crucial role as a coenzyme in a step of normal synthesis of myelin. Likewise, it is a vital coenzyme in the synthesis of neurotransmitters. Therefore, it is no surprise that vitamin B12 deficiency is linked to a spectrum of neuropsychiatric disorders. Most physicians can quickly pick up typical pernicious anemia, but very few remember the association of vitamin B12 with neuropsychiatric disorders. In this case report, the author presents his own experience of neuropsychiatric disorder (presenting as carpal tunnel syndrome along with anxiety) related to vitamin B12 deficiency with a strong recommendation to include vitamin B12 in the initial set of laboratory investigations suggested for patients over 40 years of age presenting with neuropsychiatric disorders.
Deficiency of vitamin B12 and its relation with neurological disorders: a critical review
The Journal of Basic and Applied Zoology
B12 is an essential vitamin for human body which reduces the chances of neurological diseases, birth defects, and chronic disorders. It is a vital micro-nutrient for maintaining the brain health. This review sorts out some causes of vitamin B12 (B12) deficiency and develops its link with neurological disorders. The portals include PubMed, Google Scholar, Directory of Open Access Journals (DOAJ), Pak MediNet, and Science Direct were search for literature retrieval. Study of literature revealed that deficiency of this vitamin occurs primarily due to insufficient dietary intake which results in a group of neurological symptoms in adults as well as infants. These neurological disorders include apathy, anorexia, irritability, growth retardation, and developmental regression. It may also involve in delayed myelination or demyelination of neurons. It was concluded that B12 is vital micro-nutrient for healthy brain in children, younger, and elders. Various conditions are responsible for def...
Journal of Evolution of medical and Dental Sciences, 2013
BACKGROUND: Vitamin B12 (Cobalamin) plays an important role in DNA synthesis and neurologic function. Deficiency can lead to a wide spectrum of hematologic and neuropsychiatric disorders that can often be reversed by early diagnosis and prompt treatment. MATERIAL AND METHODS: Cross sectional descriptive study carried out in Medicine department, SMIMER, Surat during the period from June 2009 to December 2010. 30 patients whose Serum Vitamin B12 level <250 pg/ml were included. RESULT: The most common complaint was fatigue present in 29(96.7%) followed by anorexia, present in 19(63.3%) patients. Anemia was observed in 25(83.3%) patients. Out of this 25 patients with anemia 13(52%) patients had leucopenia, and 15(60%) patients had thrombocytopenia (platelet count<150000/cumm), while 10 (40%) patient had normal platelet count. 13(52%) out of 25 anemic patients had MCV of 80-100 fl, while 11(44%) had MCV more than 100 fl. 15 patients had neurological features, myeloneuropathy (4 pat...