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The peripheral neuropathy of vitamin B12 deficiency

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      Abstract

      Nerve conduction studies and sural nerve biopsy were performed on three patients with vitamin B12 deficiency and symptoms of peripheral neuropathy. The pathological findings were those of axonal degeneration; there was no evidence of demyelination. The patients were reviewed at intervals of 5–15 years commencement of treatment; progression of the neuropathy had been arrested by treatment, but in all cases residual neurological abnormalities persisted. In one patient with autonomic neuropathy, the postural hypotension resolved rapidly and fully with treatment.

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      References

        • Bannerji N.K.
        • Hurwitz L.J.
        Nervous system manifestations after gastric surgery.
        Acta Neurol. Scand. 1971; 47: 485-513
        • Bischoff A.
        • Lutsche J.
        • Meier C.
        Polyneuropathie bei Vitamin B12 und Folsäuremangel.
        Münch. Med. Wschr. 1975; 117: 1593-1598
        • Chanarin I.
        • Deacon R.
        • Perry J.
        • Lumb M.
        Annotation.
        Brit. J. Haem. 1981; 47: 487-491
        • Cox-Klazinga M.
        • Endtz L.J.
        Peripheral nerve involvement in pernicious anaemia.
        J. Neurol. Sci. 1980; 45: 367-371
        • Craig A.J.
        • Jacobson W.
        The methylation in vitro of myelin basic protein by arginine methylase from mouse spinal cord.
        Biochem. Soc. Trans. 1980; 8: 619-620
        • Dynes J.B.
        • Norcross J.W.
        Peripheral neuritis as a complication of pernicious anaemia.
        J. Amer. Med. Ass. 1943; 122: 586-588
        • Eisenhofer G.
        • Lambie D.G.
        • Johnson R.H.
        • Tan E.
        • Whiteside E.A.
        Deficient catecholamine release as the basis of orthostatic hypotension in pernicious anaemia.
        J. Neurol. Neurosurg. Psychiat. 1982; 45: 1053-1055
        • Fine E.J.
        • Hallet M.
        Neurophysiological study of subacute combined degeneration.
        J. Neurol. Sci. 1980; 45: 331-336
        • Foster D.B.
        Degeneration of peripheral nerves in pernicious anaemia.
        Arch. Neurol. Psychiat. 1945; 54: 102-109
        • Frenkel E.P.
        Abnormal fatty acid metabolism in peripheral nerves of patients with pernicious anaemia.
        J. Clin. Invest. 1973; 52: 1237-1245
        • Gilliatt R.W.
        • Goodman H.V.
        • Willison R.G.
        The recording of lateral popliteal nerve action potentials in man.
        J. Neurol. Neurosurg. Psychiat. 1961; 24: 305-318
        • Greenfield J.G.
        • Carmichael E.A.
        The peripheral nerve in cases of subacute combined degeneration of the cord.
        Brain. 1935; 58: 483-491
        • Horton M.A.
        • Oliver R.T.D.
        HLA phenotype A2:B12 in vitamin B12 neuromyelopathy.
        J. Neurol. Sci. 1977; 32: 79-89
        • Kosik K.S.
        • Mullins T.S.
        • Bradley W.G.
        • Tempelis L.D.
        • Cretelle A.J.
        Coma and axonal degeneration in vitamin B12 deficiency.
        Arch. Neurol. (Chic.). 1980; 37: 590-592
        • Low P.A.
        • McLeod J.G.
        • Prineas J.W.
        Hypertrophic Charcot-Marie-Tooth disease.
        J. Neurol. Sci. 1978; 35: 93-115
        • McLeod J.G.
        • Evans W.A.
        Peripheral neuropathy in spinocerebellar degenerations.
        Muscle and Nerve. 1981; 4: 51-61
        • McLeod J.G.
        • Walsh J.C.
        • Little J.M.
        Sural nerve biopsy.
        Med. J. Aust. 1969; 2: 1092-1096
        • Mayer R.F.
        Peripheral nerve function in vitamin B12 deficiency.
        Arch. Neurol. (Chic.). 1965; 13: 355-362
        • Minot G.R.
        • Murphy W.P.
        Treatment of pernicious anaemia by a special diet.
        J. Amer. Med. Ass. 1926; 87: 470-476
        • Pallis C.A.
        • Lewis P.D.
        The neurology of gastro-intestinal disease.
        in: Major Problems in Neurology. Vol. 3. W. B. Saunders, Philadelphia1974: 30-86
        • Pant S.
        • Asbury A.K.
        • Richardson E.P.
        The myelopathy of pernicious anaemia — A neuropathological reappraisal.
        Acta Neurol. Scand. 1968; 44: 1-36
        • Reynolds E.H.
        The neurology of vitamin B12 deficiency.
        Lancet. 1976; i: 832-833
        • Roos D.
        Neurological complications in patients with impairment of B12 absorption following partial gastrectomy.
        Acta Neurol. Scand. 1978; 59: 1-36
        • Russell J.S.R.
        • Batten F.E.
        • Collier J.
        Subacute combined degeneration of the spinal cord.
        Brain. 1900; 23: 39-110
        • Schaumberg H.H.
        • Spence P.S.
        • Thomas P.K.
        Disorders of the Peripheral Nerves.
        in: F.A. Davis, Philadelphia1983: 65
        • Sharma A.K.
        • Thomas P.K.
        Quantitative studies on age changes in unmyelinated fibres in the vagus nerve in man.
        in: Kunze K. Desmedt J.E. Studies on Neuromuscular Diseases. Karger, Basel1975: 211-219
        • Ungley C.C.
        Subacute combined degeneration of the cord, Part 1 (Response to liver extracts); Part 2 (Trials with vitamin B12).
        Brain. 1949; 72: 382
        • Ungley C.C.
        • Suzmann M.M.
        Subacute combined degeneration of the cord — Symptomatology and effects of liver therapy.
        Brain. 1929; 52: 271-294
        • Victor M.
        • Lear A.A.
        Subacute combined degeneration of the spinal cord.
        Amer. J. Med. 1961; 20: 896-911
        • Victor M.
        Polyneuropathy due to nutritional deficiency.
        in: Dyck P.J. Thomas P.K. Lambert E.H. Peripheral Neuropathy. W.B. Saunders, Philadelphia1975: 1054-1966
        • Walsh J.C.
        • McLeod J.G.
        Alcoholic neuropathy — An electrophysiological and histological study.
        J. Neurol. Sci. 1970; 10: 457-469
        • White W.B.
        • Reik L.
        • Cutlip D.E.
        Pernicious anaemia seen initially as orthostatic hypotension.
        Arch. Int. Med. 1981; 141: 1543-1544
        • Williams J.A.
        • Hal G.S.
        • Thompsen A.G.
        • Cooke W.T.
        Neurological disease after partial gastrectomy.
        Brit. Med. J. 1969; III: 210-212
        • Woltman H.W.
        The nervous symptoms in pernicious anaemia — An analysis of one hundred and fifty cases.
        Amer. J. Med. Sci. 1919; 157: 400-409