Vitamin B12 deficiency in a child presenting with epileptic spasms

Abstract

Vitamin B12 deficiency may cause a wide variety of signs and symptoms such as macrocytic anemia, neurodevel- opmental delay or regression, cerebral atrophy, polyneuropathy, paresthesias, degeneration of spinal cord, ataxia, irritability, weakness, hypotonia, apathy, tremor, seizures, and neuropsychiatric disorders such as schizophrenia and dementia. However, its association with epileptic spasms has been reported in only one patient before. Thus, the role of coincidence or association remains controversial. This article presents a 10-month-old girl with B12 deficiency presenting with epileptic spasms, psy- chomotor regression, and suppression-burst pattern on electroencephalography. After exclusion of other causes of epileptic spasms such as hypoxic ischemic encephalopathy, cortical malformations, or neurodegenerative diseases through extensive neuroimaging and laboratory investigations, epileptic spasms were regarded as the presenting clinical picture of underlying vitamin B12 deficiency. Epileptic spasms may be a neurologic manifestation of underlying vitamin B12 deficiency.