幻觉和维生素B12缺乏:一个系统的审查
Jan Dirk Blom1,2,3
1Outpatient Clinic for Uncommon Psychiatric Syndromes, Parnassia Psychiatric Institute, The Hague, The Netherlands.
Psychopathology
|July 24, 2024
概括
维生素B12缺乏会导致幻觉,通常是视觉或听觉幻觉,这些幻觉通常会通过巴胺治疗得到缓解. 这表明神经系统和血液相关的缺陷症状有不同的途径.
科学领域:
- 神经学 神经学
- 精神病学是一个精神病学.
- 营养科学 营养科学
背景情况:
- 维生素B12缺乏通常与神经系统疾病有关,如恶性贫血和多神经病.
- 新出现的证据表明,维生素B12缺乏与幻觉发生之间的联系越来越大.
研究的目的:
- 系统地审查和分析与维生素B12缺乏相关的幻觉的案例研究.
- 了解这些幻觉的特征,治疗结果和影响.
主要方法:
- 在PubMed,PsycINFO和Google Scholar进行了系统的文献搜索,截至2023年7月1日.
- 分析的重点是1960年至2023年间发表的50个案例研究,详细介绍了与维生素B12缺乏相关的幻觉.
主要成果:
- 幻觉主要是视觉和/或听觉,其中20%被描述为复杂.
- 这些幻觉经常发生在其他神经精神疾病的背景下,通常通过可巴拉明治疗 (75%完全,25%在2个月内部分改善) 得到解决.
- 值得注意的是,四分之一的治疗耐药幻觉病例通过可巴胺单一治疗得到解决,只有32%的患者患有并发性恶性贫血,这表明了单独的症状途径.
结论:
- 在无法解释的幻觉的情况下,应考虑维生素B12缺乏,特别是考虑到其高患病率.
- 这些发现表明,维生素B12缺乏的感知和血液症状具有不同的神经路径.
- 由于素食主义和娱乐性氧化使用等风险因素的增加,提高意识至关重要.
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