Dorsal sural nerve conduction study in vitamin B12 deficiency with megaloblastic anemia (original) (raw)
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The peripheral neuropathy of vitamin B12 deficiency
Journal of The Neurological Sciences, 1984
Nerve conduction studies and sural nerve biopsy were performed on three patients with vitamin B12 deficiency and symptoms of peripheral neuropathy. The pathological findings were those of axonal degeneration; there was no evidence of demyelination. The patients were reviewed at intervals of 5–15 years commencement of treatment; progression of the neuropathy had been arrested by treatment, but in all cases residual neurological abnormalities persisted. In one patient with autonomic neuropathy, the postural hypotension resolved rapidly and fully with treatment.
Central sensory and motor conduction in vitamin B12 deficiency
Four patients with subacute combined degeneration were studied through upper and lower limb SEPs recorded with a non2cephalic reference montage and through cortical and spinal magnetic stimulation. Clinical signs were confined to the lower limbs in 3 patients; the remaining patient presented only paraesthesiae in 4 limbs. Median nerve SEPs showed a normal cervical N13 response with a significant increase of central conduction time concerning exclusively the P9-P14 interpeak interval. Central motor conduction to upper and lower limb muscles was abnormal. Nerve conduction studies provided no evidence of peripheral nerve involvement. These electrophysiological findings suggest that in vitamin B12 deficiency the higher segments of the cervical cord are usually affected first and that central sensory and motor conduction studies are sensitive methods for detecting such damage.
Vitamin B12 deficiency neuropathy; a rare diagnosis in young adults: a case report
Background: Vitamin B12 deficiency is a metabolic disorder with many causes. It often presents with megaloblastic anaemia and neurological disorders which entail prompt treatment. The diagnosis of Vitamin B12 deficiency is chal‑ lenging in resource limited‑settings due to limited access to diagnostic tools and unfamiliarity with the disease, owing to its rarity especially in young people. Case presentation: A 28 year old female Cameroonian presented with progressive burning painful sensations on the upper trunk, paraesthesia and numbness of the upper and lower limbs for a period of 5 years. Before presenting to us, she had consulted in numerous health institutions for which she had been treated for diverse pathologies with no relieve of symptoms. After clinical and laboratory evaluation, a diagnosis of vitamin B12 deficiency‑associated neuropathy was made. She was placed on oral vitamin B12 supplements at 2 mg daily for 3 months. Follow up was marked by good clinical recovery after 1 month of therapy. Conclusion: Vitamin B12 deficiency neuropathy is a rare debilitating disease that affects mostly the elderly. However; young adults with neuropathic symptoms warrant a high index of suspicion. Peripheral blood smears and complete blood counts are sufficiently diagnostic in resource‑limited settings.
Journal of Surgery and Medicine
Background/Aim: Vitamin B12 is essential for normal neural conduction in peripheral nerves. This study aimed to investigate the electrophysiological profile for varying degrees of serum B12 levels and to determine whether a correlation existed between electrophysiological profiles and serum methylmalonic acid (MMA) levels. Also, determination of subclinical peripheral nerve involvement with cold administration was planned in serum B12 levels. Methods: A total of 101 (63 females, 38 males) subjects with known serum vitamin B12 levels were selected randomly from the neurology outpatient clinic for this study. The subjects were divided into three groups based on the serum total Vitamin B12 levels: (1) B12 deficiency (<126 pg/mL), (2) low B12 (126-250 pg/mL), and (3) normal B12 (250–500 pg/mL). Serum MMA and nerve conduction studies (NCS) were assessed and compared between the three groups. After the cooling procedure was applied to the ulnar and sural nerves, NCS was repeated. Resul...
Management of Peripheral Neuropathy and Cardiovascular Effects in Vitamin B12 Deficiency
Journal of Biomedical and Pharmaceutical Research, 2021
Peripheral nerves are susceptible to damage by a wide array of toxins, medications, and vitamin deficiencies. Vitamin B12 (VB12) deficiency neuropathy is a rare debilitating disease that affects mostly the elderly. It is important to consider these etiologies when approaching patients with a variety of neuropathic presentations in this review were have included most relevant and latest information on mechanisms causing Peripheral neuropathy in VB12 deficiency. We also have included cardiovascular disorders and their management. Hyperhomocysteinemia has been implicated in endothelial dysfunction and cardiovascular disease. The association of homocysteine (Hcy) and VB12 with cardiovascular risk factors in patients with coronary artery disease (CAD) has also been studied Keywords: Peripheral Neuropathy, Vitamin B12 Deficiency, Cardiovascular Disease and Homocysteine.
Vitamin B12 neuropathy in a 6 year old
Archives of Disease in Childhood, 1984
Gross neuropathy consequent upon selective malabsorption of vitamin B12 was diagnosed in a 6 year old Bangladeshi girl brought to Great Britain for further investigation of an unexplained illness of three years' duration. The initial peripheral blood count was normal. Treatment with vitamin B12 has led to substantial recovery.
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.
Efficacy of Vitamin B1, B6, and B12 Forte Therapy in Peripheral Neuropathy Patients
Diponegoro International Medical Journal, 2021
Background: Peripheral neuropathy can be caused by diabetes mellitus, nutritional deficiencies, entrapment or Carpal Tunnel Syndrome (CTS), and idiopathic.Objective: To determine the therapeutic efficacy of Vitamin B1, B6, and B12 forte in relieving symptoms of peripheral neuropathy.Methods: This was pre- and post-experimental study involving patients with moderate peripheral neuropathy (Toronto Clinical Neuropathy Score [TCNS] ≥6 and Michigan Neuropathy Screening Instrument [MNSI] ≥7) taken from outpatient neurological clinic of Dr. Kariadi Hospital, Semarang. The patient was prescribed Vit B1 100 mg, B6 100 mg, and B12 5000 mcg once daily for 2 months. Evaluation of the numerical pain rating scale in the form of VAS and Total Symptom Score (TSS) was conducted at the first and second month. The VAS score difference test was conducted with the Wilcoxon test and TSS with the Post Hoc test and considered significant if p <0.05.Results: There were 30 patients aged 18 - 65 years, con...