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[Cobalamin deficiency: neurological aspects in 27 cases]
H El Otmani1, F Moutaouakil, N Midafi
1Service de neurologie et d'explorations fonctionnelles, CHU Ibn-Rochd, Casablanca, Maroc. hichamotmani@hotmail.com
Revue Neurologique
|December 6, 2008
Summary
Cobalamin (B12) deficiency frequently causes neurological issues like combined medullar sclerosis and neuropathies. Autonomic dysfunction can reveal deficiency, responding well to vitamin replacement, especially when diagnosed early.
Area of Science:
- Neurology
- Endocrinology
- Hematology
Context:
- Cobalamin (B12) deficiency is a common cause of neurological disorders.
- Combined medullar sclerosis and peripheral neuropathies are frequent manifestations.
- Biermer's disease is a primary cause, but other etiological factors exist.
Purpose:
- To analyze the clinical and etiological aspects of neurological manifestations in patients with cobalamin deficiency.
- To investigate the role of autonomic dysfunction as an early sign of B12 deficiency.
- To assess the impact of nitrous oxide exposure on latent cobalamin deficiency.
Summary:
- This retrospective study analyzed 27 patients with neurological symptoms and confirmed cobalamin deficiency.
- Combined medullar sclerosis (67%) and sensory neuropathies (30%) were common. Autonomic dysfunction was noted in 6 patients, revealing deficiency with rapid improvement after B12 therapy.
- Biermer's disease was diagnosed in 63%. Nitrous oxide triggered deficiency decompensation in 19% of cases, particularly after anesthesia.
Impact:
- Highlights the frequency of autonomic dysfunction as a presenting sign of cobalamin deficiency.
- Emphasizes the risk of neurological decompensation from nitrous oxide in patients with latent B12 deficiency.
- Underscores the importance of early diagnosis and vitamin replacement for favorable neurological outcomes.
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