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• Vol.56 No.7
• CLINICA NEUROL, 56: 499−503, 2016
• Vol.56 No.7 contents

Case Report

A case of vitamin B₁₂ deficiency with involuntary movements and bilateral basal ganglia lesions

Taisuke Kitamura, M.D.¹⁾, Seiji Gotoh, M.D.¹⁾²⁾, Hayato Takaki, M.D.¹⁾, Fumi Kiyuna, M.D.¹⁾, Sohei Yoshimura, M.D.¹⁾ and Kenichiro Fujii, M.D.¹⁾

¹⁾Department of Cerebrovascular Disease, Fukuoka Red Cross Hospital
²⁾Department of Cerebrovascular Medicine and Neurology, National Hospital organization, Kyushu Medical Center

An 86-year-old woman with a one-year history of dementia was admitted to our hospital complaining of loss of appetite, hallucinations, and disturbance of consciousness. She gradually presented with chorea-like involuntary movements of the extremities. Diffusion-weighted magnetic resonance imaging (MRI) showed bilateral symmetrical hyperintense signals in the basal ganglia. The serum vitamin B₁₂ level was below the lower detection limit of 50 pg/ml. The homocysteine level was markedly elevated at 115.8 nmol/ml. Anti-intrinsic factor and anti-parietal cell antibody tests were positive. Gastrointestinal endoscopy revealed atrophic gastritis. The patient was diagnosed with encephalopathy due to vitamin B₁₂ deficiency caused by pernicious anemia. Involuntary movements and MRI abnormalities improved with parenteral vitamin B₁₂ supplementation. Bilateral basal ganglia lesions are rare manifestations of adult vitamin B₁₂ deficiency. The present case is considered valuable in identifying the pathophysiology of involuntary movement due to vitamin B₁₂ deficiency.
Full Text of this Article in Japanese PDF (588K)

(CLINICA NEUROL, 56: 499−503, 2016)
key words: vitamin B₁₂ deficiency, involuntary movement, basal ganglia, pernicious anemia

(Received: 8-Mar-16)