Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2020 , Vol 11, Issue 1
Neurological Findings of Vitamin B12 Deficiency In Children: Analysis of 120 Patients
Elif Acar Arslan1
1Karadeniz Teknik Üniversitesi, Tıp Fakültesi Hastanesi, Çocuk Nörolojisi Bilim Dalı, Trabzon, Türkiye DOI : 10.31067/0.2019.196 Purpose: The aim of this study is to systematically identify the neurological findings of vitamin B12 deficiency in children.

Patients and Methods: From the patients aged from 6 months to 18 years who presented to our clinic between 15 January 2014, and 15 September 2015, and evaluated retrospectively, 120 subjects meeting the study criteria from 7007 patient admissions were included. Patients were divided into six groups based on neurological findings. Patients" demographic characteristics, clinical symptoms, examination findings, laboratory values, and imaging and electrophysiological characteristics were recorded.

Results: Mean serum B12 level was 160.409 pg/mL according to reported data. It has been shown that twenty-two patients with borderline low or normal vitamin B12 levels (190 pg/mL-263 pg/mL) and neurological findings associated with B12 deficiency had high serum homocysteine levels for their age. The most common symptom was dizziness and/or syncope (Group 3; 74/120, 61.7%). Group 1 consisted of patients with a history of poor school performance, concentration difficulty and forgetfulness (n=22, 18.3%), Group 2 of patients with congenital hypotonicity (n=5, 3.3%), Group 3 of patients with dizziness and/or syncope (vertigo n=51, 42.5% ; syncope n=23, 19.2%); Group 4 of patients with numbness and/or formication (n=13, 10.8%), and Group 5 of patients with symptoms from more than one group (n=7, 5.8%).

Conclusion: Vitamin B12 levels must be investigated in all patients, particularly those with congenital hypotonicity, with reflexes present and with dizziness and syncope. Homocysteine can show a deficiency in normal patients with neurological findings of Vitamin B12 deficiency but with borderline B12 levels. It is important to protect the nervous system against permanent damage when clinical signs of the disease fully develop. Treatment before the emergence of hematological findings such as anemia and mean corpuscular volume elevation will be useful in reducing damage to a minimum. A dynamic approach to neurological findings will prevent possible sequelae. Keywords : Vitamin B12 deficiency, neurological system findings, homocysteine