Berri Maha Ait, Taous Abdellah, Boulahri Tarik, Traibi Imane, Rouimi Abdelhadi
Service de Neurologie, Hôpital Militaire Moulay Ismaïl, Meknès, Maroc.
Pan Afr Med J. 2019 Mar 8;32:108. doi: 10.11604/pamj.2019.32.108.17609. eCollection 2019.
Neurological disorders secondary to vitamin B12 deficiency are polymorphic and diverse. There have been very few studies conducted in the Moroccan as well as in the African population. This study aims to describe the clinical, paraclinical, evolutionary features of neurological manifestations in patients with vitamin B12 deficiency within the Department of Neurology at the Moulay Ismail Military Hospital, Meknes over a period of 18 years (1999-2017). The study involved 06 women and 23 men, with an average age of 57 years. The mean time between symptom onset and diagnosis was 3 months. Neurological manifestation was indicative of vitamin B12 deficiency in 100% of cases. The average hemoglobin level was 10 g/dl, the mean corpuscular volume was 115 fl. Medullary megaloblastosis and atrophic gastritis were found in 95% and 90% of cases respectively. Regular electromyography (EMG), electroencephalography (EEG) and visual evoked potentials (VEP) showed subclinical peripheral and optic neuropathies. In 20 cases they were caused by Biermer's anemia. All the patients received parenteral Vitamin B12 with good outcome. These results demonstrate the importance of early diagnosis in patients with a potentially serious neuropsychiatric condition as well as of rapid substitution treatment which is the only therapeutic option to secure a good outcome.
维生素B12缺乏继发的神经系统疾病具有多态性且多种多样。在摩洛哥以及非洲人群中进行的研究非常少。本研究旨在描述梅克内斯穆莱·伊斯梅尔军事医院神经内科18年(1999 - 2017年)期间维生素B12缺乏患者神经表现的临床、副临床及演变特征。该研究纳入了6名女性和23名男性,平均年龄为57岁。症状出现至诊断的平均时间为3个月。100%的病例中神经表现提示维生素B12缺乏。平均血红蛋白水平为10 g/dl,平均红细胞体积为115 fl。分别在95%和90%的病例中发现了骨髓巨幼细胞贫血和萎缩性胃炎。常规肌电图(EMG)、脑电图(EEG)和视觉诱发电位(VEP)显示亚临床周围神经和视神经病变。其中20例由恶性贫血引起。所有患者接受了胃肠外维生素B12治疗,效果良好。这些结果表明,对于患有潜在严重神经精神疾病的患者,早期诊断以及快速替代治疗非常重要,而快速替代治疗是确保良好预后的唯一治疗选择。