Open AccessReversible dementia, psychotic symptoms and epilepsy in a patient with vitamin B12 deficiency
Author(s) -
Bruno Silva,
Ana Velosa,
Bernardo Barahona-Corrêa
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-229044
Subject(s) - medicine , dementia , glossitis , pernicious anaemia , pediatrics , epilepsy , psychosis , vitamin b12 , vitamin d deficiency , pernicious anemia , psychiatry , disease , anemia , vitamin d and neurology , pathology , tongue
Vitamin B 12 deficiency is a common condition, typically associated with megaloblastic anaemia, glossitis and neuropsychiatric symptoms. We report the case of a patient presenting with progressive cognitive and functional deterioration, psychosis and seizures, later found to be secondary to pernicious anaemia. Importantly, the diagnosis of pernicious anaemia was only established 5 years after symptom onset and was overlooked even when the patient was under medical care, in part due to the lack of classic neurological and haematological signs associated with the condition. The patient had a remarkable neuropsychiatric recovery after vitamin replacement and psychopharmacological management. We discuss similar presentations of vitamin B 12 deficiency found in the literature, symptom reversibility and the importance of its early recognition and treatment.