vitamin-b-12 and Dyskinesia--Drug-Induced

Seizures and epilepsy are a common problem in childhood. Nonepileptic paroxysmal events are conditions that can mimic seizure and frequent in early childhood. Nonepileptic paroxysmal events can be due to physiological or exaggerated physiological responses, parasomnias, movement disorders, behavioral or psychiatric disturbances, or to hemodynamic, respiratory, or gastrointestinal dysfunction. Vitamin B12 deficiency is a treatable cause of failure to thrive and developmental regression, involuntary movements, and anemia. Involuntary movements rarely may appear a few days after the initiation of vitamin B12 treatments and might be misdiagnosed as seizure. Here, we report 2 patients who presented with involuntary movements with his video image.

Topics: Atrophy; Brain; Breast Feeding; Clonazepam; Diagnostic Errors; Dyskinesia, Drug-Induced; Electroencephalography; Emergencies; Epilepsies, Partial; Female; Growth Disorders; Humans; Infant; Injections, Intramuscular; Magnetic Resonance Imaging; Male; Milk, Human; Psychomotor Agitation; Status Epilepticus; Vitamin B 12; Vitamin B 12 Deficiency

It has been known for many years that vitamin B12 deficiency can cause neurologic problems. One of these problems is involuntary movements that can appear both before and after the initiation of vitamin B12 treatment. Here, we report 3 infants who developed movement disorder during vitamin B12 administration. The movement disorder consisted of a combination of tremor and myoclonus affecting face, tongue, and limbs. Because of the severity of the symptoms, they all needed symptomatic treatment. In 2 of them, the involuntary movements resolved with clonazepam. The involuntary movements in the other patient were successfully treated with piracetam.

Topics: Anticonvulsants; Clonazepam; Dyskinesia, Drug-Induced; Female; Humans; Infant; Male; Piracetam; Severity of Illness Index; Treatment Outcome; Vitamin B 12

Topics: Dyskinesia, Drug-Induced; Humans; Vitamin B 12

Involuntary movements may be a symptom in most infants who present with neurologic syndrome of infantile cobalamin (vitamin B12) deficiency. In this report, two infants with cobalamin deficiency are presented. These patients also developed a striking movement disorder that appeared a few days after treatment with intramuscular cobalamin. The movement disorder was characterized by severe involuntary movements, which were a combination of tremor and myoclonus particularly involving tongue, face, pharynx, and legs. The neurologic symptoms improved within a few days after the administration of clonazepam. In each patient the mother was also cobalamin deficient and the infant was solely breast-fed. The cause of involuntary movements that can appear rarely after treatment in infantile cobalamin deficiency is not known. Besides initial neurologic presenting symptoms of cobalamin deficiency, the occurrence of involuntary movements after treatment should also receive attention. This movement disorder may disappear spontaneously, or an additional treatment may be an alternative approach if the symptoms are severe.

Topics: Anticonvulsants; Breast Feeding; Clonazepam; Diagnosis, Differential; Dyskinesia, Drug-Induced; Female; Humans; Infant; Injections, Intramuscular; Nutrition Disorders; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency