Serial nerve conduction studies in vitamin B12 deficiency-associated polyneuropathy
- 2 October 2010
- journal article
- case report
- Published by Springer Science and Business Media LLC in Neurological Sciences
- Vol. 32 (1), 183-186
- https://doi.org/10.1007/s10072-010-0428-9
Abstract
This report is on a 22-year-old male vegetarian with acute polyneuropathy secondary to vitamin B12 deficiency. He presented with weakness and numbness of the distal limbs and absent deep tendon reflex in all four extremities. Nerve conduction study (NCS) showed an axonal type sensori-motor polyneuropathy. Serum biochemical studies revealed vitamin B12 level of 119 pg/mL (reference range 185–710 pg/mL), with elevated creatine kinase (CK) (719 U/L) and homocysteine (Hcy) (24.04 μmol/L) levels. Anti-parietal cell antibody test was positive. The patient received both oral and intramuscular injection of vitamin B12. The amplitude of the median and ulnar motor NCS increased 2.5 months later, while muscle power of the ankle plantar flexion and dorsiflexion recovered after 3.5 and 5.5 months, respectively. Follow-up NCS after 14.5 months showed response in sural NCS, but not the peroneal NCS. Follow-up also showed decreased serum Hcy and CK to 9.6 μmol/L and 198 U/L, respectively, and increasing amplitude of response. Recovery sequence involved muscle power of the proximal muscles, hands, plantar flexion, and dorsiflexion of the feet, and followed by sensory conduction.Keywords
This publication has 10 references indexed in Scilit:
- How I treat cobalamin (vitamin B12) deficiencyBlood, 2008
- Vitamin B12 and methylmalonic acid levels in patients presenting with polyneuropathyMuscle & Nerve, 2007
- Comparison of clinical and electrodiagnostic features in B12 deficiency neurological syndromes with and without antiparietal cell antibodiesPublished by Oxford University Press (OUP) ,2007
- Vitamin B12 deficiency: a clinical and electrophysiological profile.2005
- Challenges in the Identification of Cobalamin-Deficiency PolyneuropathyArchives of Neurology, 2003
- Axonal and demyelinating neuropathy with reversible proximal conduction block, an unusual feature of vitamin B12 deficiencyMuscle & Nerve, 1998
- Myths About Vitamin B12 DeficiencySouthern Medical Journal, 1991
- Neurologic Aspects of Cobalamin DeficiencyMedicine, 1991
- The neurophysiological profile of vitamin B12 deficiencyMuscle & Nerve, 1990
- The neuropsychiatry of megaloblastic anaemia.BMJ, 1980