vitamin-b-12 and Movement-Disorders

The neurocutaneous syndrome of infantile B12 deficiency, more commonly called the infantile tremor syndrome, typically is characterized by developmental delay, sparse hair, hyperpigmentation, and tremors. When treated with injectable B12, the affected babies can develop a peculiar transient "batwing dystonia." This dystonia is possibly a nutritional recovery movement disorder due to basal ganglia dysfunction.

Topics: Dystonia; Dystonic Disorders; Humans; Infant; Movement Disorders; Tremor; Vitamin B 12; Vitamin B 12 Deficiency

In developed countries, the vitamin B12 deficiency usually occurs in children exclusively breast-fed, whose mothers are vegetarians, causing low stores of vitamin B12. Symptoms of vitamin B12 deficiency appear during the second trimester of life and include failure to thrive, lethargy, hypotonia, and arrest or regression of developmental skills. A megaloblastic anemia can be present. One half of the infants exhibit abnormal movements before the start of treatment with intramuscular cobalamin, which disappear 1 or 2 days after. More rarely, movement disorders appear a few days after treatment, whereas neurological symptoms are improving. These abnormal movements can last for 2 to 6 weeks. If not treated, vitamin B12 deficiency can cause lasting neurodisability. Therefore, efforts should be directed to preventing deficiency in pregnant and breast-feeding women on vegan diets and their infants by giving them vitamin B12 supplements. When preventive supplementation has failed, one should recognize and treat quickly an infant presenting with failure to thrive and delayed development.

Topics: Breast Feeding; Developmental Disabilities; Diet, Vegetarian; Failure to Thrive; Humans; Infant; Male; Movement Disorders; Vitamin B 12; Vitamin B 12 Deficiency

The unknown biochemical basis for neurologic dysfunction in cobalamin deficiency and the frequent divergence between neurologic and hematologic manifestations led us to study homocysteine metabolism in 22 patients with pernicious anemia. Serum levels of total homocysteine (tHcy), methionine, S-adenosylmethionine (AdoMet), cysteine, cysteinylglycine (cys-gly), and glutathione (GSH) were measured. Only levels of tHcy and cysteine were increased and only GSH was decreased in cobalamin deficiency as a whole, compared with 17 control subjects. AdoMet correlated only with methionine levels (P =.015) and cysteine only with cys-gly (P =.007) in healthy subjects, but in cobalamin-deficient patients AdoMet correlated instead with cysteine, cys-gly, and folate levels only (P =.008, P =.03, and P =.03, respectively). Significant differences appeared in clinically subgrouped cobalamin-deficient patients. The 11 patients with neurologic defects had higher mean levels of folate (27.9 versus 15.4 nM), AdoMet (117.2 versus 78.6 nM), cysteine (462 versus 325 microM), and cys-gly (85.0 versus 54.7 microM) than the 11 neurologically unaffected patients. Cobalamin therapy restored all metabolic changes to normal. The results indicate that changes in several metabolic pathways differ in patients with and without neurologic dysfunction. Cysteine levels were the most significant predictors of neurologic dysfunction, but it is unclear if they are direct or indirect indicators of neurotoxicity. The higher AdoMet levels in neurologically affected patients may result from inhibition of glycine N-methyltransferase by those patients' higher folate levels. The origin of the folate differences is unclear and possibly varied. Low AdoMet and GSH levels were independent predictors of anemia.

Topics: Anemia; Anemia, Pernicious; Cysteine; Dipeptides; Folic Acid; Glutathione; Homocysteine; Humans; Memory Disorders; Methionine; Movement Disorders; Nervous System Diseases; Retrospective Studies; S-Adenosylmethionine; Sensation Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Biological Products; Evaluation Studies as Topic; Female; Humans; Joint Diseases; Male; Middle Aged; Movement Disorders; Peptides; Pyridoxine; Thiamine; Tissue Extracts; Vitamin B 12

Topics: Adenine; Allopurinol; Athetosis; Bone Marrow; Carbon Isotopes; Child; Child, Preschool; Chorea; Compulsive Behavior; Diet Therapy; Erythrocytes; Folic Acid; Glycine; Humans; Intellectual Disability; Male; Metabolism, Inborn Errors; Movement Disorders; Purines; Self Mutilation; Transferases; Uric Acid; Vitamin B 12

Topics: Adolescent; Cerebellar Diseases; Cerebral Palsy; Child; Corrinoids; Drug Therapy; Electric Stimulation Therapy; Galantamine; Humans; Hyperkinesis; Infant; Movement Disorders; Vitamin B 12