Reversible disconnection syndrome: An unusual presentation of vitamin B12 deficiency

Verma, Rajesh; Raut, Tushar Premraj; Praharaj, Heramba Narayan

doi:10.4103/0028-3886.111126

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…The disconnection syndrome of PCA territory infarct of dominant hemisphere due to vitamin B12 deficiency has been reported in the literature. 4 Verma et al in their case report found Alexia as an additional symptom due to infarction of spenicial part of the corpus callosum of dominant side. 4 But in our case as the involvement of infarct is on the nondominant side, we did not encounter any such symptoms.…”

Section: Discussionmentioning

confidence: 94%

“…4 Verma et al in their case report found Alexia as an additional symptom due to infarction of spenicial part of the corpus callosum of dominant side. 4 But in our case as the involvement of infarct is on the nondominant side, we did not encounter any such symptoms. However recent memory loss in our case is probably attributed to the presence of thalamic infarct.…”

Section: Discussionmentioning

confidence: 94%

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Homonymous hemianopia: An unusual presentation of vitamin B 12 deficiency

Chowdhury¹

2019

IJOOO

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A 24 years male presented with a headache for one year, recent memory loss and loss of left hemifield of vision for three months. Upon examination, visual acuity was found to be 20/20 in both eyes. Automated perimetry revealed left homonymous hemianopia with sparing of the macula. Right thalamic infarct and subacute infarct in the territory of the right posterior cerebral artery (PCA) were the findings on CT scan. Except for decreased vitamin B12 level and increased homocysteine level in serum, rest of the serological, biochemical, hormonal and immunological investigations were within normal limits. MRI of the brain showed right PCA infarct and few ischemic foci in bilateral periventricular regions. MR Angiogram revealed relatively reduced flow in the right PCA and right vertebral artery. The patient was managed with antiplatelet drugs and supplementation of vitamin B12. Marked improvement was noticed in a headache and memory loss and there was normalization of field defect after 6 months of treatment. Cases of homonymous hemianopia in neuro-ophthalmology are not unusual, but the etiology and course of this case report make an interesting variation.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Homonymous hemianopia: An unusual presentation of vitamin B 12 deficiency

Chowdhury¹

2019

IJOOO

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“…The literature contains two case reports of SE due to cobalamin deficiency, mostly presenting with seizures associated with psychotic phenomena or other CNS symptoms (Aguglia et al ., ; Kumar, ). Kumar et al .…”

Section: Discussionmentioning

confidence: 99%

“…Kumar et al . () reported a case of vitamin B12 deficiency with multiple neuropsychiatric manifestations, such as dementia, psychosis, recurrent seizures, and myeloneuropathy, while Aguglia et al . () reported a case that developed a partial complex epileptic confusional status (ECS), unresponsive to acute iv diazepam.…”

Section: Discussionmentioning

confidence: 99%

Cobalamin deficiency triggering de novo status epilepticus

Anastogiannis

Karanasios

Makridou

et al. 2014

Epileptic Disorders

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Cobalamin deficiency is included in the spectrum of very uncommon underlying causes of status epilepticus (SE) and the literature contains very few such cases. We herein report a case of unusual presentation of cobalamin (vitamin B12) deficiency with de novo SE with the intention to bolster the argument that a de novo manifestation of SE due to cobalamin deficiency might not be that uncommon. We also support the importance of prompt identification and treatment of the underlying causes of SE, particularly those which are uncommon.

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“…Malnutrition has also been shown to impact neurotransmitters in rats (Agarwal et al, 1981; Schweigert et al, 2005; Wood et al, 1979), and it is known that the immune system is dysregulated in AN (Gibson & Mehler, 2019), both of which can alter the seizure threshold. Micronutrient deficiencies could also impact the seizure threshold (Keyser & De Bruijin, 1991; Kretsch et al, 1991; Kumar, 2004; Ramaekers et al, 1994). Thiamine, a cofactor for multiple enzymes involved in energy metabolism and with increased requirements during times of high metabolic need, was indeed found to be deficient in 38% of individuals with AN in one study (Winston et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Seizures in eating disorders

Gibson

Watters

Bauschka

2023

Intl J Eating Disorders

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ObjectiveTo complete a descriptive study of seizure etiology in a large population of eating disorder (ED) patients and to better understand whether malnutrition itself, in those with EDs, is associated with seizure development.MethodIn this retrospective study, 75 patients with documented seizures met inclusion criteria from a total of 1664 charts.ResultsPrevalence of seizures in this ED cohort was found to be 4.5%, with 29.3% of individuals experiencing seizures due to psychogenic nonepileptic seizures (PNES). Other common causes of seizures included substance abuse/withdrawal (18.7%), primary seizure disorder (12%), and electrolyte abnormalities/hypoglycemia (10.7%). Three patients (4%) also developed their seizures presumably due to Wernicke's encephalopathy (WE).DiscussionSeveral etiologies of seizures are reported from this large sample of ED patients, and this is also the first study to report on a possible association of WE as a cause of seizures in ED patients. The contribution of WE and malnutrition toward the development of seizures in this population remains to be determined, and future studies should also seek to better understand the inter‐relationship between malnutrition and the other variables discussed in this article, such as hypomagnesemia, toward seizure development.Public significanceThe medical complications of EDs are myriad but seizures have not historically been considered one of those direct complications of malnutrition. The findings of this retrospective study suggest that seizure development may be a direct and indirect complication associated with EDs. The presentation of Wernicke's encephalopathy, which can also be associated with development of seizures, requires further investigation in those with EDs.

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Reversible disconnection syndrome: An unusual presentation of vitamin B12 deficiency

Cited by 6 publications

References 8 publications

Homonymous hemianopia: An unusual presentation of vitamin B 12 deficiency

Homonymous hemianopia: An unusual presentation of vitamin B 12 deficiency

Cobalamin deficiency triggering de novo status epilepticus

Seizures in eating disorders

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