Journal
JOURNAL OF THE NEUROLOGICAL SCIENCES
Volume 273, Issue 1-2, Pages 152-154Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jns.2008.06.034
Keywords
cerebellar ataxia; chorea; hyperhomocystinemia; vitamin B-12 deficiency; Wernicke's aphasia
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Patients with vitamin B-12 deficiency have protean neurological manifestations that are often insidious. Acute onset of cerebellar dysfunction and extrapyramidal manifestations like dystonia and chorea are rather uncommon in adults. We describe a patient who manifested with acute onset of language dysfunction, chorea and ataxia. There was no history of hypertension, diabetes or ischemic heart disease. He had low serum vitamin B-12 and elevated serum homocystine levels. He improved dramatically following B-12 replacement therapy. Our patient Provides insight into the pathophysiological mechanism of this rare manifestation. Further the importance of considering vitamin B-12 deficiency, in country like India, where vegetarian food practice is quite common, is being emphasized. (c) 2008 Elsevier B.V. All rights reserved.
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