Vitamin B12 Deficiency Neuropathy Research Articles

Task-specific walking training improves walking ability in an individual with vitamin B12 deficiency peripheral neuropathy: a case report

Introduction. A 32-year-old man, diagnosed with vitamin B12 deficiency neuropathy by means of laboratory parameters and electroneuromiography, and presented 3 month history of mild weakness of both lower limbs, associated with gait disturbances, fall history and fatigue. Method. After the pre-treatment evaluate, he started the exercise therapy program. To elucidate the therapeutic effects of exercise therapy program, the TUG, 10MWT and 6MWT was performed to evaluate the fall risk, gait speed, gait endurance and ability to walk over longer distances and functionality at the pre-treatment baseline, 90 days and 180 days of exercise therapy program. Results. After 180-days of intervention, he showed an improvement on TUG test, totalizing an improvement of 31% when compared to the baseline time (5.1 seconds faster). On the 10MWT, the gait speed improvement presented an increased of 50% compared to the baseline speed. On the last walking distance assessment, at 180-days of intervention, the participant also showed an improvement of endurance, reaching 284 meters in 6 minutes of confortable walking. Conclusion. The described exercise therapy program for this patient resulted in improved walk ability after 180-days of intervention, including gait speed, gait endurance, ability to walk over longer distances and fall risk.

Vitamin B12 deficiency neuropathy: A clinical and electrophysiological study

Objectives Vitamin B12 deficiency is a metabolic disorder with many causes. The neurological features of vitamin B12 deficiency are heterogeneous [2] . Peripheral neuropathy often described [3] , but its frequency and its type is controversial [1] . The present study was conducted to describe electro-clinical presentations of peripheral neuropathy in patients with vitamin B12 deficiency. Methods A Retrospective review of 32 subjects with neurological abnormalities due to vitamin B12 deficiency, were subjected to a detailed motor and sensory nerve conduction studies of median, ulnar, external popliteal sciatic, internal popliteal sciatic and sural nerves. Patients that have another reason for neuropathy or another disease that can effect nerve conduction studies were excluded. Results The median age of the patients was 51 (± 16.57) years old, (range 18–84 years old), sex ratio (M/F) was 1.66 (20/12). Clinical features of neuropathy: paraesthesia, hyporeflexia, ataxia and limb weakness were present in 20 (62.5%) patients. Electromyography showed abnormal nerve conduction in 25 (78.12%) patients and it was normal in 7 (21.88%) patients. On nerve conduction study: 16 (50%) had axonal impairment, 3 (9.3%) had demyelinating neuropathy and 6 (18.75%) had mixed features. Eleven patients (34.37%) presented a pure sensory impairment and 14 (43.75%) presented mixed pattern sensory and motor impairment. All cases underwent treatment with intramuscular hydroxocobalamin treatment (daily injection of 1000 μg cyanocobalamin for 4 weeks, followed by injections of 1000 μg each month) with marked clinical and haematological improvement. Conclusion We conclude that nearly 80% patients with neurologic manifestations of vitamin B12 deficiency had evidence of peripheral neuropathy which is mainly axonal with some demyelinating features. Sensory and motor nerve conduction were affected. Evolution is generally good if the treatment was initiated early.

Vitamin B12 deficiency neuropathy; a rare diagnosis in young adults: a case report

BackgroundVitamin 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 challenging 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 presentationA 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.ConclusionVitamin 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.

Diabetes mellitus and pernicious anemia.

From 1959 to 1968, thirty-six cases of pernicious anemia (PA) were noted in 11,144 patients with diabetes mellitus (DM) at the Joslin Clinic (incidence 3.2/1,000). Of the thirty-six, only one was not insulin dependent. The female to male ratio was 7:5. Age ranged from thirty-four to eighty-one years. In twenty-eight patients with DM, a mean period of 12.6 years elapsed from time of diagnosis of diabetes mellitus to development of PA. In eight, PA preceded DM by a mean period of 6.6 years. Vitamin B12 deficiency neuropathy was present in nine patients and in only six of these was there clinically recognizable anemia. Hypothyroidism was present in two patients. Histochemical and immune abnormalities common to both disorders are reviewed and possible causes for association are discussed.