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Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886 EISSN: 1998-4022
Vol. 53, Num. 1, 2005, pp. 120-120

Neurology India, Vol. 53, No. 1, January-March, 2005, pp. 120

Letter To Editor

Vitamin B12 deficiency presenting with an acute reversible extrapyramidal syndrome

Movement Disorders Program, Foothills Hospital, University of Calgary, Alberta
Correspondence Address:Movement Disorders Program, Foothills Hospital, University of Calgary, Alberta
Email: joymacan@yahoo.co.in

Code Number: ni05036

Sir,

I read with interest the report of acute reversible extrapyramidal syndrome presumably caused by vitamin B12 deficiency by Sudhir Kumar.[1] If this finding can be replicated, we may have another neurological manifestation caused by deficiency of vitamin B12. Probably from now on we should look for extrapyramidal manifestations in patients with deficiency of this vitamin.

Dr. Sudhir′s report also tells the importance of giving credence to simple investigations like complete blood count and peripheral smear examination. This could give unexpected and remarkable results as far as treatment is concerned at least in a few number of patients. Such observations could go a long way as far as clinical medicine is concerned.

I have a slight objection to the statement made by Kumar about the diagnosis. He states in the case report section "a diagnosis of acute onset parkinsonism with mild myeloneuropathy secondary to vitamin B12 deficiency was made" during the initial stage when the patient was seen. Because there had never been any report in the literature of such an observation in the past, it would have been difficult to attribute the patient′s symptoms and signs to vitamin B12 deficiency after the initial evaluation. But once we see that the patient responds to treatment, we can presume that probably, the manifestations were due to the vitamin deficiency.

References

1.Kumar S. Vitamin B12 deficiency presenting with an acute reversible extrapyramidal syndrome. Neurol India 2004;52:507-9.  Back to cited text no. 1    

Copyright 2005 - Neurology India

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