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Involuntary movements misdiagnosed as seizure during vitamin B12 treatment
Kursat Bora Carman1, Tugba Belgemen, Uluc Yis
1From the Divisions of *Pediatric Neurology and †Pediatric Hematology, Gaziantep Children's Hospital, Gaziantep, Turkey.
Insights
Vitamin B12 deficiency can cause developmental regression and anemia. Involuntary movements may rarely emerge during treatment, mimicking seizures in children.
Area of Science:
- Pediatric Neurology
- Nutritional Neuroscience
Background:
- Childhood seizures and epilepsy are common neurological issues.
- Nonepileptic paroxysmal events frequently mimic seizures in young children.
- Vitamin B12 deficiency is a treatable cause of developmental regression, anemia, and movement disorders.
Observation:
- Two pediatric patients presented with involuntary movements.
- The involuntary movements occurred shortly after initiating Vitamin B12 treatment.
- These movements were video-documented for analysis.
Findings:
- Involuntary movements post-Vitamin B12 treatment can be mistaken for seizures.
- This highlights a potential diagnostic challenge in pediatric neurology.
- Early recognition is crucial for appropriate management.
Implications:
- Clinicians should consider Vitamin B12 treatment-induced movement disorders in children presenting with seizure-like activity.
- Accurate diagnosis prevents unnecessary anti-epileptic drug administration.
- This underscores the importance of a thorough medical history and observation in pediatric cases.
Abstract:
Seizures and epilepsy are a common problem in childhood. Nonepileptic paroxysmal events are conditions that can mimic seizure and frequent in early childhood. Nonepileptic paroxysmal events can be due to physiological or exaggerated physiological responses, parasomnias, movement disorders, behavioral or psychiatric disturbances, or to hemodynamic, respiratory, or gastrointestinal dysfunction. Vitamin B12 deficiency is a treatable cause of failure to thrive and developmental regression, involuntary movements, and anemia. Involuntary movements rarely may appear a few days after the initiation of vitamin B12 treatments and might be misdiagnosed as seizure. Here, we report 2 patients who presented with involuntary movements with his video image.
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