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Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review.
J Child Neurol. 2015 Nov; 30(13):1831-7.JC

Abstract

We studied 27 infants aged 6 to 27 months with vitamin B12 deficiency also known as "infantile tremor syndrome" in India. All were exclusively breast-fed by vegetarian mothers. Developmental delay or regression, pallor, skin hyperpigmentation, and sparse brown hair were present in all. Majority were hypotonic and involuntary movements were encountered in 18. Anemia and macrocytosis was found in 83% and 71% infants, respectively. Low serum vitamin B12 was present in 12 of 21 infants. Seven of the 9 infants with normal serum vitamin B12 had received vitamin B12 before referral. Twelve mothers had low serum vitamin B12. Cerebral atrophy was present in all the 9 infants who underwent neuroimaging. Treatment with vitamin B12 resulted in dramatic improvement in general activity and appetite within 48 to 72 hours followed by return of lost milestones. Tremors resolved in all by 3 to 4 weeks. Nutritional vitamin B12 deficiency is a treatable cause of neurologic dysfunction in infants.

Authors+Show Affiliations

Division of Pediatric Neurology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India gorayajs@gmail.com.Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

25953825

Citation

Goraya, Jatinder Singh, et al. "Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review." Journal of Child Neurology, vol. 30, no. 13, 2015, pp. 1831-7.
Goraya JS, Kaur S, Mehra B. Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review. J Child Neurol. 2015;30(13):1831-7.
Goraya, J. S., Kaur, S., & Mehra, B. (2015). Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review. Journal of Child Neurology, 30(13), 1831-7. https://doi.org/10.1177/0883073815583688
Goraya JS, Kaur S, Mehra B. Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review. J Child Neurol. 2015;30(13):1831-7. PubMed PMID: 25953825.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review. AU - Goraya,Jatinder Singh, AU - Kaur,Sukhjot, AU - Mehra,Bharat, Y1 - 2015/05/07/ PY - 2015/01/20/received PY - 2015/03/25/accepted PY - 2015/5/9/entrez PY - 2015/5/9/pubmed PY - 2016/8/11/medline KW - infants KW - nutritional KW - vegetarianism KW - vitamin B12 deficiency SP - 1831 EP - 7 JF - Journal of child neurology JO - J Child Neurol VL - 30 IS - 13 N2 - We studied 27 infants aged 6 to 27 months with vitamin B12 deficiency also known as "infantile tremor syndrome" in India. All were exclusively breast-fed by vegetarian mothers. Developmental delay or regression, pallor, skin hyperpigmentation, and sparse brown hair were present in all. Majority were hypotonic and involuntary movements were encountered in 18. Anemia and macrocytosis was found in 83% and 71% infants, respectively. Low serum vitamin B12 was present in 12 of 21 infants. Seven of the 9 infants with normal serum vitamin B12 had received vitamin B12 before referral. Twelve mothers had low serum vitamin B12. Cerebral atrophy was present in all the 9 infants who underwent neuroimaging. Treatment with vitamin B12 resulted in dramatic improvement in general activity and appetite within 48 to 72 hours followed by return of lost milestones. Tremors resolved in all by 3 to 4 weeks. Nutritional vitamin B12 deficiency is a treatable cause of neurologic dysfunction in infants. SN - 1708-8283 UR - https://www.unboundmedicine.com/medline/citation/25953825/Neurology_of_Nutritional_Vitamin_B12_Deficiency_in_Infants:_Case_Series_From_India_and_Literature_Review_ L2 - https://journals.sagepub.com/doi/10.1177/0883073815583688?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -