title: Rare sensory and autonomic disturbances associated with vitamin B12 deficiency.
abstract: Vitamin B12 deficiency is an important nutritional disorder causing neurological manifestations of myelopathy, neuropathy and dementia. Sub-acute combined degeneration (SCD) with involvement of the posterior columns in the cervical and thoracic cord is a common presentation of this disorder. In this case report, we describe a 43 year old woman with pernicious anemia and myelopathy with atypical clinical features. The patient presented with motor symptoms, a sensory level and bladder dysfunction. She had severe autonomic disturbances including an episode of unexplained bronchospasm, which has not been previously reported as a manifestation of vitamin B12 deficiency. We review the literature regarding these rarely reported features of vitamin B12 deficiency, and discuss aspects of management of this reversible condition. We emphasize the importance of awareness of autonomic disturbances in B12 deficient individuals.
authors.affiliation: Department of Neurology, Wayne State University School of Medicine/Detroit Medical Center, 4201 St Antoine, Detroit, MI 48201, United States.
authors.forename: Preeti
authors.initials: P
authors.lastname: Puntambekar
authors.forename: Maysaa M
authors.initials: MM
authors.lastname: Basha
authors.forename: Imad T
authors.initials: IT
authors.lastname: Zak
authors.forename: Ramesh
authors.initials: R
authors.lastname: Madhavan
mesh_terms: D000328:Adult; D000752:Anemia, Pernicious / Q000209:etiology / Q000378:metabolism; D001342:Autonomic Nervous System Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D001980:Bronchi / Q000294:innervation / Q000503:physiopathology; D001986:Bronchial Spasm / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007866:Leg / Q000294:innervation / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D009434:Neural Pathways / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D020335:Paraparesis / Q000209:etiology / Q000503:physiopathology; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology; D013116:Spinal Cord / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D052879:Subacute Combined Degeneration / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology; D014805:Vitamin B 12 / Q000008:administration & dosage; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000188:drug therapy
chemical_list: D014805:Vitamin B 12