Neurological Manifestations Of Vitamin B-12 Deficiency


N Sethi, E Robilotti, Y Sadan. Neurological Manifestations Of Vitamin B-12 Deficiency. The Internet Journal of Nutrition and Wellness. 2004 Volume 2 Number 1.


Vitamin B-12 deficiency is a common problem encountered in developing countries of the world. In Europe and North America it is frequently encountered in the elderly and in people whose diets are compromised such as alcoholics. Recent data has shown that cobalamin deficiency may occur in 5% to 40% of the general population. The prevalence as stated earlier is higher in the elderly and in nursing home residents. Vitamin B-12 deficiency may take decades to develop and patients may be asymptomatic or may present with a wide spectrum of hematological and neuropsychiatric manifestations. The history of research in Vitamin B-12 deficiency is fascinating and the noble prize has been awarded twice to investigators involved in it.

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Psychosis in Vitamin B12 Deficiency

Arch Intern Med. 1971;128(4):596-597. doi:10.1001/archinte.1971.00310220104015.

Vitamin B12 deficiency may present with a psychosis which is curable if treated promptly.1-8Although this fact is not new and is described in various textbooks,9,10 it seems that it is often forgotten, which results in prolonged suffering from irreversible brain damage.1 Accordingly, the following case report is presented to reemphasize the value of recognizing and promptly treating “megaloblastic madness.”

Patient Summary  A 53-year-old Negro woman was admitted to the District of Columbia General Hospital for the first time on Sept 12, 1968, because of psychosis and anemia. She had become increasingly anorectic for two months before admission and lost 13.6 kg (30 lb). During the last month she had become unmanageable at home by refusing all food, defecating and urinating in bed, and failing to recognize her husband. She was fearful that various unknown persons would harm her and had to be led by the


Febrile pancytopenia and psychosis revealing pernicious anemia.

Minerva Med. 2003 Jun;94(3):187-90.


Hematology Division, General Hospital, Annemasse, France.


The rare case of a 42-year-old woman of African origin presenting with persecution mania leading to admission to a psychiatric hospital is reported. The outcome was rapidly marked by febrile pancytopenia and ataxia leading to the diagnosis of pernicious anemia. Although the hematologic abnormalities and mania were corrected within 2 weeks under vitamin therapy, neural improvement was slower as observed classically. The literature regarding pancytopenia and psychiatric presentations is briefly reviewed, suggesting that vitamin B(12) deficiency may induce paranoid delusion.

[PubMed – indexed for MEDLINE]

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