Involuntary Movements in Cobalamin Deficiency

Area of Science:

• Pediatric Neurology
• Nutritional Neuroscience
• Developmental Pediatrics

Background:

• Nutritional vitamin B12 (cobalamin) deficiency is a known cause of neurologic problems in infants.
• Key neurologic consequences include developmental delays, regression, and involuntary movements.

Purpose of the Study:

• To investigate the characteristics of involuntary movements in infants with cobalamin deficiency.
• To compare the onset of involuntary movements relative to vitamin B12 supplementation.

Main Methods:

• Retrospective review of medical records of infants diagnosed with cobalamin deficiency.
• Categorization of infants with involuntary movements into two groups: those developing movements during supplementation (Group I) and those prior to supplementation (Group II).

Main Results:

• Out of 32 infants with cobalamin deficiency, 12 exhibited involuntary movements.
• Group I (n=6) and Group II (n=6) showed distinct movement patterns, with Group II predominantly displaying choreoathetoid movements, twitching, myoclonus, and tremor.
• Involuntary movements in both groups resolved within 1-3 weeks with clonazepam therapy.

Conclusions:

• Early recognition of nutritional cobalamin deficiency is crucial for accurate differential diagnosis of involuntary movements in infants.
• Distinguishing cobalamin deficiency from seizures or other causes prevents unnecessary aggressive treatments.