Do neurological disorders occur without hematological findings in vitamin B12 and/or folic acid deficiency?

Vitamin B12 and folic acid deficiency lead to morphologically indistinguishable megaloblastic anemia and also may cause neuro-psychiatric syndromes by similar neuropathological mechanisms. Vitamin B12 and folic acid has indispensable roles in the structure of the central nervous system in all age groups. Vitamin B12 deficiency is seen in children with malnutrition, in children of mothers who are strict vegetarians or with pernicious anemia. Folic acid deficiency can occur as a result of malabsorption or dietary deficiency. Megaloblastic anemia; most common in children between the ages of 6 months and 2 years, and is expected to develop rarely after the age of 5. Majority of school children with megaloblastic anemia has a history of chronic diarrhea, intestinal malabsorption syndrome or surgical operation. This article will focus specifically on the fact that vitamin B12 deficiency or folic acid deficiency can cause neurological signs without megaloblastic anemia. Another reality is that if there is no anemia or hematologic findings, neurological signs are more severe. Neurological signs are inversely correlated with hematologic findings. The more severe the one is, the milder the other one can be. According to previous knowledge, folic acid without vitamin B12 only corrects hematological findings, but folic acid treatment will delay the diagnosis and treatment of neurological disorders with vitamin B12 deficiency. However, in recent years, the administration of folic acid is reported to be toxic for the neurological system in the situation of vitamin B12 deficiency, suggesting that the authors have drawn attention to another dimension of the event. Pam Med J 2014;8(2):166-170