Incecik Faruk, Hergüner M Ozlem, Altunbaşak Sakir, Leblebisatan Göksel
Divisions of Pediatric Neurology, Department of Pediatrics, tukurova University Faculty of Medicine, Adana, Turkey.
Turk J Pediatr. 2010 Jan-Feb;52(1):17-21.
We report herein our interesting case series of 15 infants admitting with neurological symptoms who were found to have vitamin B12 deficiency. Infants who were admitted to our hospital between 2004 and 2007 with neurological symptoms and were found to have vitamin B12 deficiency were included in this study. Data regarding clinical and laboratory features were obtained. Of 15 infants, 9 were boys (60%) and 6 were girls (40%). The mean age was 11.7 months. Anorexia, pallor, hypotonia, and neurodevelopmental retardation were present in all infants. Seizures and tremor were observed in 46.6% (7/15) and 33% (5/15) of patients, respectively. Seizures were generalized tonic-clonic in 4 patients, generalized tonic in 1 patient and focal in 2 patients. Four patients had tremor on admission and 1 patient had occurrence after vitamin B12 treatment. Vitamin B12 deficiency may lead to serious neurological deficits in addition to megaloblastic anemia. Persistent neurological damage can be prevented with early diagnosis and treatment. We believe that a thorough clinical and neurological assessment might prevent failure to notice rare but possible vitamin B12 deficiency in infants with neurological deficits and neurodevelopmental retardation.
我们在此报告一系列有趣的病例,15名因神经症状入院的婴儿被发现患有维生素B12缺乏症。本研究纳入了2004年至2007年间因神经症状入院且被发现患有维生素B12缺乏症的婴儿。获取了有关临床和实验室特征的数据。15名婴儿中,9名是男孩(60%),6名是女孩(40%)。平均年龄为11.7个月。所有婴儿均有厌食、面色苍白、肌张力低下和神经发育迟缓。分别有46.6%(7/15)和33%(5/15)的患者观察到癫痫发作和震颤。4例患者癫痫发作表现为全身性强直阵挛,1例为全身性强直,2例为局灶性发作。4例患者入院时出现震颤,1例患者在维生素B12治疗后出现震颤。维生素B12缺乏除了可导致巨幼细胞贫血外,还可能导致严重的神经功能缺损。早期诊断和治疗可预防持续性神经损伤。我们认为,全面的临床和神经学评估可能会避免在患有神经功能缺损和神经发育迟缓的婴儿中漏诊罕见但可能存在的维生素B12缺乏症。