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[Neurological manifestations of vitamin B12 deficiency: a retrospective study of 26 cases].
Rev Med Interne. 2006 Jun; 27(6):442-7.RM

Abstract

PURPOSE

Neurological symptoms of B12 vitamin deficiency are polymorph. Causes are dominated by Biermer's disease and B12 vitamin non dissociation that is frequent in the elderly.

METHODS

We realized a retrospective study during 11 years. Patients with neurological symptoms associated to megaloblastosis were included. Treatment with B12 vitamin lead to haematological manifestation regression.

RESULTS

26 cases were analyzed. Mean age was 50+/-14.5 years and there were 11 women and 15 men. Neurological signs included combined medullar sclerosis (N = 10), peripheral neuropathy (N = 10), isolated paresthesia (N = 5) and inferior limb pyramidal syndrome (N = 1). Neurological signs revealed vitamin B12 deficiency in 4 cases. Mean haemoglobin rate was 6.2+/-2.6 g/dl, mean MCV was 109+/-56 fl. Eight patients had macrocytic anaemia, nine bi-cytopenia and eight deep pancytopenia. Electromyography (N = 8) confirmed neuropathy and medullar MRI (N = 2) showed antero-posterior cordonal demyelinisation of cervico-dorsal medulla. Causes of B12 vitamin deficiency were Biermer's disease (N = 11), non dissociation of B12 vitamin's syndrome (N = 8) and partial gastrectomy (N = 1). In 6 patients, no aetiology was found. Treatment with parenteral vitamin B12 induced neurological symptoms regression in 14 cases. Patient with neurological disorder had significantly higher platelet count and haemoglobin level as compared with patients without neurological disorder. Reticulocyte crisis was more precocious in patients with neurological disorders.

CONCLUSION

Neurological symptoms in vitamin B12 deficiency are frequent. We insist on isolated forms, inaugural forms and on the interest of medullar MRI for early diagnosis.

Authors+Show Affiliations

Maamar M
Service de médecine interne, CHU Ibn Sina, Rabat, Maroc.
Tazi-Mezalek Z
No affiliation info available
Harmouche H
No affiliation info available
Ammouri W
No affiliation info available
Zahlane M
No affiliation info available
Adnaoui M
No affiliation info available
Aouni M
No affiliation info available
Mohattane A
No affiliation info available
Maaouni A
No affiliation info available

MeSH

AdultAgedAged, 80 and overAnemia, PerniciousElectromyographyEvoked PotentialsFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNervous System DiseasesPeripheral Nervous System DiseasesRetrospective StudiesTreatment OutcomeVitamin B 12Vitamin B 12 DeficiencyVitamin B Complex

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

fre

PubMed ID

16540210

Citation

Maamar, M, et al. "[Neurological Manifestations of Vitamin B12 Deficiency: a Retrospective Study of 26 Cases]." La Revue De Medecine Interne, vol. 27, no. 6, 2006, pp. 442-7.
Maamar M, Tazi-Mezalek Z, Harmouche H, et al. [Neurological manifestations of vitamin B12 deficiency: a retrospective study of 26 cases]. Rev Med Interne. 2006;27(6):442-7.
Maamar, M., Tazi-Mezalek, Z., Harmouche, H., Ammouri, W., Zahlane, M., Adnaoui, M., Aouni, M., Mohattane, A., & Maaouni, A. (2006). [Neurological manifestations of vitamin B12 deficiency: a retrospective study of 26 cases]. La Revue De Medecine Interne, 27(6), 442-7.
Maamar M, et al. [Neurological Manifestations of Vitamin B12 Deficiency: a Retrospective Study of 26 Cases]. Rev Med Interne. 2006;27(6):442-7. PubMed PMID: 16540210.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Neurological manifestations of vitamin B12 deficiency: a retrospective study of 26 cases]. AU - Maamar,M, AU - Tazi-Mezalek,Z, AU - Harmouche,H, AU - Ammouri,W, AU - Zahlane,M, AU - Adnaoui,M, AU - Aouni,M, AU - Mohattane,A, AU - Maaouni,A, Y1 - 2006/02/28/ PY - 2005/07/12/received PY - 2006/01/20/accepted PY - 2006/3/17/pubmed PY - 2006/8/23/medline PY - 2006/3/17/entrez SP - 442 EP - 7 JF - La Revue de medecine interne JO - Rev Med Interne VL - 27 IS - 6 N2 - PURPOSE: Neurological symptoms of B12 vitamin deficiency are polymorph. Causes are dominated by Biermer's disease and B12 vitamin non dissociation that is frequent in the elderly. METHODS: We realized a retrospective study during 11 years. Patients with neurological symptoms associated to megaloblastosis were included. Treatment with B12 vitamin lead to haematological manifestation regression. RESULTS: 26 cases were analyzed. Mean age was 50+/-14.5 years and there were 11 women and 15 men. Neurological signs included combined medullar sclerosis (N = 10), peripheral neuropathy (N = 10), isolated paresthesia (N = 5) and inferior limb pyramidal syndrome (N = 1). Neurological signs revealed vitamin B12 deficiency in 4 cases. Mean haemoglobin rate was 6.2+/-2.6 g/dl, mean MCV was 109+/-56 fl. Eight patients had macrocytic anaemia, nine bi-cytopenia and eight deep pancytopenia. Electromyography (N = 8) confirmed neuropathy and medullar MRI (N = 2) showed antero-posterior cordonal demyelinisation of cervico-dorsal medulla. Causes of B12 vitamin deficiency were Biermer's disease (N = 11), non dissociation of B12 vitamin's syndrome (N = 8) and partial gastrectomy (N = 1). In 6 patients, no aetiology was found. Treatment with parenteral vitamin B12 induced neurological symptoms regression in 14 cases. Patient with neurological disorder had significantly higher platelet count and haemoglobin level as compared with patients without neurological disorder. Reticulocyte crisis was more precocious in patients with neurological disorders. CONCLUSION: Neurological symptoms in vitamin B12 deficiency are frequent. We insist on isolated forms, inaugural forms and on the interest of medullar MRI for early diagnosis. SN - 0248-8663 UR - https://www.unboundmedicine.com/medline/citation/16540210/[Neurological_manifestations_of_vitamin_B12_deficiency:_a_retrospective_study_of_26_cases]_ DB - PRIME DP - Unbound Medicine ER -