Abstract
OBJECTIVE: Deficiency of Vit.B12 may present initially with non-specific sensory symptoms or a chronic pain syndrome and we sought to identify the prevalence of B12 deficiency in such patients. BACKGROUND:Vitamin B12 is essential for neurological function and CNS integrity. The deficiency of Vit.B12 may be unnoticed thoughrampant in those who are on strict vegan diet or taking proton pump inhibitors. It may present with sensory symptoms of limbs, difficulty in walking, stiffness of limbs, recurrent falls, memory impairment, visual blurring and psychosomatic illness including depression. A chronic pain syndrome can also occur due to Vit.B12 deficiency. DESIGN/METHODS: Patients attending the Neurology outpatient clinic, as well as inpatients, with ill-defined chronic pain, and other non-specific sensory symptoms - not conforming to any nerve territory or typical pattern, underwent serum Vit. B12 estimation. RESULTS:There were 70 patients, 19 males and 51 females. Age ranged from 10 to 91 Yrs. Minimum value of Vit.B 12 recorded was 19pg/ml. 11 patients had value < 100pg/ml. 21 patients (34[percnt]) has absolute deficiency < 200pg/ml and 66[percnt] had relative deficiency - 200 to 500pg/ml. Most of these patients had sensory symptoms of limbs (76[percnt]), and vague body pain (82[percnt]), often reported in a unilateral distribution (63[percnt]). Premature greying (92[percnt]) and mild pallor (44[percnt]) were common. Dietary history showed vegetarian diet (12[percnt]) or conversion to strict vegetarianism including milk due to Ayurvedic treatment (22[percnt]) or frequent usage of proton pump inhibitors (48[percnt]) . Advice from consultants to avoid fatty food also led to abstinence from non-vegetarian diet. CONCLUSIONS:There is a high prevalence of Vit B12 deficiency in patients presenting with ill-defined chronic pain and other non-specific sensory symptoms. Vit B12 is a correctable nutritional deficiency and such may be the initial manifestation. This has to be treated to prevent progression to neuropathy, myelopathy and dementia.
Disclosure: Dr. Ummer has nothing to disclose. Dr. Noone has nothing to disclose.
Tuesday, April 21 2015, 2:00 pm-6:30 pm
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