[Orthostatic hypotension revealing vitamin B12 deficiency]

Neurological manifestations of cobalamin deficiency are well known and various. We describe an uncommon clinical setting where major orthostatic hypotension was the primary symptom. Recovery was rapidly and completely stabilized with parenteral cobalamin substitution. There was no clinical or electrophysiological signs of neuropathic disorder. This entity is rare but few cases are described in literature. All of them were reversible with vitamin substitution treatment.