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Peripheral Neuropathy Due to Cobalamin Deficiency.

David S. Saperstein1, Richard J. Barohn

  • 1*Department of Neurology, Wilford Hall Medical Center, 2200 Bergquist Drive, Suite 1, San Antonio, TX 78236-5300, USA. sapers@pol.net

Current Treatment Options in Neurology
|April 5, 2002
PubMed
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Vitamin B12 (cobalamin) deficiency can cause neurological issues like myelopathy and dementia. Early detection using methylmalonic acid and homocysteine testing is crucial, as treatment may prevent further neurological decline.

Area of Science:

  • Neurology
  • Clinical Medicine
  • Biochemistry

Background:

  • Vitamin B12 (cobalamin, Cbl) deficiency is linked to various neurological complications.
  • Myelopathy, or combined systems disease, is a recognized manifestation of Cbl deficiency.
  • The role of peripheral neuropathy as an isolated symptom of Cbl deficiency is debated and not well-characterized.

Purpose of the Study:

  • To investigate the prevalence and clinical/electrophysiologic features of peripheral neuropathy in Cbl deficiency.
  • To highlight the limitations of standard serum Cbl assays in detecting deficiency.
  • To explore the utility of serum metabolites for improved Cbl deficiency diagnosis.

Main Methods:

  • Review of existing literature on Cbl deficiency and neurological manifestations.

Related Experiment Videos

  • Analysis of clinical and electrophysiologic data related to Cbl deficiency peripheral neuropathy.
  • Evaluation of diagnostic accuracy of serum Cbl assays versus metabolite testing (methylmalonic acid, homocysteine).

    • Main Results:

    • Peripheral neuropathy may be the sole presenting sign of Cbl deficiency, though its features are not well-defined.
    • Standard serum Cbl assays may lack sensitivity in identifying all deficient patients.
    • Testing methylmalonic acid and homocysteine can enhance the detection of Cbl deficiency.

    Conclusions:

    • Neurological complications, including peripheral neuropathy, are significant consequences of Vitamin B12 deficiency.
    • Enhanced diagnostic strategies incorporating serum metabolites are recommended for accurate Cbl deficiency identification.
    • While parenteral Cbl may not reverse existing deficits, it can halt progression; oral Cbl may also be effective in some cases.