Jansen Leonie, van der Linden Carolien M J
Catharina Ziekenhuis, afd. Klinische Geriatrie Eindhoven, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(2):A5132.
Ataxia due to a vitamin B12 deficiency can be a cause of falls in elderly patients.
An 86-year-old woman presented with functional decline and gait problems. She had been falling regularly. The patient's gait was ataxic and she was unable to stand without support. Additional laboratory tests showed a volume macrocytic blood picture and a severe vitamin B12 deficiency, as well as antibodies directed against intrinsic factor and parietal cells. We diagnosed her as having falls and ataxia caused by vitamin B12 deficiency. Vitamin B12 supplementation resulted in improvement of gait.
Ataxia due to vitamin B12 deficiency is a rare problem which in 20-25% of cases is not accompanied by anaemia. Prompt treatment reduces the chance of neurological sequelae.
维生素B12缺乏所致共济失调可能是老年患者跌倒的一个原因。
一名86岁女性出现功能衰退和步态问题。她经常跌倒。患者步态共济失调,无支撑时无法站立。进一步的实验室检查显示大细胞性血常规以及严重的维生素B12缺乏,还有针对内因子和壁细胞的抗体。我们诊断她患有维生素B12缺乏所致的跌倒和共济失调。补充维生素B12后步态有所改善。
维生素B12缺乏所致共济失调是一个罕见问题,20% - 25%的病例不伴有贫血。及时治疗可减少神经后遗症的发生几率。