title: Acute bilateral useless hand syndrome: a rare presenting manifestation of vitamin B12 deficiency.
abstract: We report a case of bilateral useless hand syndrome, a rare presenting manifestation of vitamin B12 deficiency. A 38-year-old man, a strict vegetarian and a teacher by occupation, presented with acute onset clumsiness of both hands while performing fine movements. Detailed history-taking, examination of the patient and relevant investigations (complete blood count, serum vitamin B12 and MRI of the cervical spinal cord) were carried out. Laboratory analysis was suggestive of vitamin B12 deficiency and MRI demonstrated a lesion involving the posterior columns of the cervical cord. The patient was diagnosed as a case of non-compressive cervical myelopathy predominantly involving the posterior column due to vitamin B12 deficiency. Acute bilateral useless hand syndrome can be a rare presenting feature of vitamin B12 deficiency.
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Sumant
authors.initials: S
authors.lastname: Biyani
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Sneh Kumar
authors.initials: SK
authors.lastname: Jha
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Suchit
authors.initials: S
authors.lastname: Pandey
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Shukla
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology; D003937:Diagnosis, Differential; D014676:Diet, Vegetarian; D005500:Follow-Up Studies; D006225:Hand / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D035583:Rare Diseases; D013116:Spinal Cord / Q000473:pathology; D013118:Spinal Cord Diseases / Q000473:pathology; D013577:Syndrome; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*