title: Retardation of myelination due to dietary vitamin B12 deficiency: cranial MRI findings.
abstract: Vitamin B12 deficiency is known to be associated with signs of demyelination, usually in the spinal cord. Lack of vitamin B12 in the maternal diet during pregnancy has been shown to cause severe retardation of myelination in the nervous system. We report the case of a 14(1)/2-month-old child of strictly vegetarian parents who presented with severe psychomotor retardation. This severely hypotonic child had anemia due to insufficient maternal intake of vitamin B12 with associated megaloblastic anemia. MRI of the brain revealed severe brain atrophy with signs of retarded myelination, the frontal and temporal lobes being most severely affected. It was concluded that this myelination retardation was due to insufficient intake of vitamin B12 and vitamin B12 therapy was instituted. The patient responded well with improvement of clinical and imaging abnormalities. We stress the importance of MRI in the diagnosis and follow-up of patients with suspected diseases of myelination.
authors.affiliation: Department of Neuroradiology, IDR, Inselspital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Lövblad
authors.forename: G
authors.initials: G
authors.lastname: Ramelli
authors.forename: L
authors.initials: L
authors.lastname: Remonda
authors.forename: A C
authors.initials: AC
authors.lastname: Nirkko
authors.forename: C
authors.initials: C
authors.lastname: Ozdoba
authors.forename: G
authors.initials: G
authors.lastname: Schroth
mesh_terms: D000749:Anemia, Megaloblastic / Q000209:etiology; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014676:Diet, Vegetarian / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D009123:Muscle Hypotonia / Q000209:etiology; D009186:Myelin Sheath / Q000502:physiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011597:Psychomotor Performance; D013702:Temporal Lobe / Q000473:pathology; D014805:Vitamin B 12 / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000188:drug therapy
chemical_list: D014805:Vitamin B 12