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Neurological Consequences of Infantile Vitamin B12 Deficiency - A Prospective Cohort Study
Pawan Kumar1, Naveen Sankhyan2, Sameer Vyas3
1Dr. Yashwant Singh Parmar Government Medical College & Hospital Nahan, Sirmaur, Himachal Pradesh, India.
Insights
Infantile vitamin B12 deficiency causes significant, lasting neurological damage in children, including developmental delays and brain abnormalities, even after treatment.
Area of Science:
- Neurology
- Pediatrics
- Nutritional Science
Background:
- Infantile vitamin B12 deficiency is a critical condition affecting brain development.
- Early diagnosis and intervention are crucial for managing neurological consequences.
Purpose of the Study:
- To investigate the neurological effects of infantile vitamin B12 deficiency.
- To assess the impact on brain structure and development.
Main Methods:
- A prospective cohort study of children with infantile B12 deficiency.
- Clinical evaluation, developmental assessment, blood tests, and brain MRI at baseline and post-treatment.
Main Results:
- 93% of children had developmental delay, 56% showed regression, and 57% had microcephaly.
- Baseline MRIs revealed widespread abnormalities in 97.2%, including corpus callosum thinning and cerebral/cerebellar atrophy.
- Follow-up MRIs showed persistent abnormalities in 67% of cases, with 67.5% exhibiting moderate to severe developmental retardation (developmental quotient < 50).
Conclusions:
- Infantile vitamin B12 deficiency leads to severe, persistent neurological deficits.
- Brain imaging and developmental assessments confirm lasting damage despite therapy.
- Effective management requires addressing nutritional deficiencies to prevent long-term cognitive impairment.
Background:
The purpose of this research is to study the neurological consequences of infantile vitamin B12 deficiency on the developing brain.
Methods:
A prospective cohort study was done in consecutive children with Infantile B12 deficiency. Clinical evaluation, developmental assessment, blood investigations, and a magnetic resonance imaging (MRI) of the brain were performed at baseline and after therapy with injectable vitamin B12.
Results:
Among 141 children (median age-13 months), developmental delay was observed in 131 (93%), and 79 (56%) had regression. Eighty (57%) babies had head circumference of < -2 Z score. At baseline, the MRI of the brain was abnormal in 137 (97.2%), showing thinning of corpus callosum (n = 133, 94.3%), cerebral cortical atrophy (n = 128, 90.8%), cerebellar atrophy (n = 126, 89.4%), atrophy of midbrain (n = 81, 57.4%) and pons (n = 78, 55.3%). A follow-up MRI done in 98 (69.5%) showed 66 (67%) had one or more residual abnormalities. The baseline full-scale developmental quotient was 22 (interquartile range: 13-30), while the follow-up full-scale developmental quotient score was 47.5 (interquartile range: 42.5-55). Seventy-nine (67.5%) had a follow-up developmental quotient of less than 50, implying moderate to severe developmental retardation.
Conclusions:
Despite therapy, children affected by the infantile B12 deficiency syndrome have significant lasting effects on the brain, evident as poor head growth, developmental deficits, and residual brain imaging changes.
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