de Souza Aaron, Moloi M W
Neurol Res. 2014 Dec;36(12):1121-8. doi: 10.1179/1743132814Y.0000000396. Epub 2014 May 22.
Deficiency of vitamin B12 produces protean effects on the nervous system, most commonly neuropathy, myelopathy, cognitive and behavioural symptoms, and optic atrophy. Involuntary movements comprise a relatively rare manifestation of this readily treatable disorder. Both adults and infants deficient in vitamin B12 may present with chorea, tremor, myoclonus, Parkinsonism, dystonia, or a combination of these, which may precede diagnosis or become apparent only a few days after parenteral replacement therapy has begun. The pathogenesis of these movement disorders shows interesting parallels to certain neurodegenerative conditions. The clinical syndrome responds well to vitamin B12 supplementation in most cases, and an early diagnosis is essential to reverse the haematological and neurological dysfunction characteristic of this disorder. In this article, we elucidate the association of vitamin B12 deficiency with movement disorders in adults and in infants, discuss the pathogenesis of this association, review previously reported cases, and present a young adult male with severe generalized chorea that showed a salutary response to vitamin B12 supplementation.
维生素B12缺乏对神经系统会产生多种影响，最常见的是神经病变、脊髓病变、认知和行为症状以及视神经萎缩。不自主运动是这种易于治疗的疾病相对罕见的一种表现。维生素B12缺乏的成人和婴儿都可能出现舞蹈症、震颤、肌阵挛、帕金森综合征、肌张力障碍或这些症状的组合，这些症状可能在诊断之前出现，或者仅在开始肠外替代治疗几天后才变得明显。这些运动障碍的发病机制与某些神经退行性疾病存在有趣的相似之处。在大多数情况下，临床综合征对补充维生素B12反应良好，早期诊断对于逆转该疾病特有的血液学和神经功能障碍至关重要。在本文中，我们阐明成人和婴儿维生素B12缺乏与运动障碍的关联，讨论这种关联的发病机制，回顾先前报道的病例，并介绍一名对补充维生素B12有良好反应的患有严重全身性舞蹈症的年轻成年男性。
