Rare sensory and autonomic disturbances associated with vitamin B12 deficiency

J Neurol Sci. 2009 Dec 15;287(1-2):285-7. doi: 10.1016/j.jns.2009.07.030. Epub 2009 Aug 31.

Abstract

Vitamin B12 deficiency is an important nutritional disorder causing neurological manifestations of myelopathy, neuropathy and dementia. Sub-acute combined degeneration (SCD) with involvement of the posterior columns in the cervical and thoracic cord is a common presentation of this disorder. In this case report, we describe a 43 year old woman with pernicious anemia and myelopathy with atypical clinical features. The patient presented with motor symptoms, a sensory level and bladder dysfunction. She had severe autonomic disturbances including an episode of unexplained bronchospasm, which has not been previously reported as a manifestation of vitamin B12 deficiency. We review the literature regarding these rarely reported features of vitamin B12 deficiency, and discuss aspects of management of this reversible condition. We emphasize the importance of awareness of autonomic disturbances in B12 deficient individuals.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Pernicious / etiology
  • Anemia, Pernicious / metabolism
  • Autonomic Nervous System Diseases / etiology*
  • Autonomic Nervous System Diseases / pathology
  • Autonomic Nervous System Diseases / physiopathology
  • Bronchi / innervation
  • Bronchi / physiopathology
  • Bronchial Spasm / etiology
  • Bronchial Spasm / physiopathology
  • Female
  • Humans
  • Leg / innervation
  • Leg / physiopathology
  • Magnetic Resonance Imaging
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / physiopathology
  • Neural Pathways / metabolism
  • Neural Pathways / pathology
  • Neural Pathways / physiopathology
  • Paraparesis / etiology
  • Paraparesis / physiopathology
  • Sensation Disorders / etiology
  • Sensation Disorders / physiopathology
  • Spinal Cord / metabolism
  • Spinal Cord / pathology
  • Spinal Cord / physiopathology
  • Spinal Cord Diseases / etiology*
  • Spinal Cord Diseases / pathology
  • Spinal Cord Diseases / physiopathology
  • Subacute Combined Degeneration / etiology*
  • Subacute Combined Degeneration / pathology
  • Subacute Combined Degeneration / physiopathology
  • Sympathetic Nervous System / metabolism
  • Sympathetic Nervous System / pathology
  • Sympathetic Nervous System / physiopathology
  • Treatment Outcome
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / physiopathology
  • Vitamin B 12 / administration & dosage
  • Vitamin B 12 Deficiency / complications*
  • Vitamin B 12 Deficiency / drug therapy

Substances

  • Vitamin B 12