Department of Neurology, Wayne State University School of Medicine/Detroit Medical Center, 4201 St Antoine, Detroit, MI 48201, United States.
J Neurol Sci. 2009 Dec 15;287(1-2):285-7. doi: 10.1016/j.jns.2009.07.030. Epub 2009 Aug 31.
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.
维生素 B12 缺乏症是一种重要的营养失调症，可导致脊髓病、神经病和痴呆的神经表现。亚急性联合变性（SCD）累及颈胸段脊髓后柱是这种疾病的常见表现。在本病例报告中，我们描述了一位 43 岁女性，患有恶性贫血和脊髓病，具有非典型的临床特征。患者表现为运动症状、感觉水平和膀胱功能障碍。她还出现严重的自主神经紊乱，包括一次不明原因的支气管痉挛，这在以前的维生素 B12 缺乏症表现中并未报道过。我们回顾了关于这种罕见的维生素 B12 缺乏症特征的文献，并讨论了这种可逆转情况的管理方面。我们强调了对 B12 缺乏个体自主神经紊乱的认识的重要性。
