Objective: we present a case series of movement disorders (MD) due to vitamin B12 deficiency (VB12D) and compare them with the cases reported in the literature.

Background: VB12D is a quite frequent cause of neurological disorders in the middle and low-income countries. Symptoms include mainly peripheral neuropathy and myelopathy. On the other hand, MD are rarely described.

Method: we retrospectively assessed the medical records of patients from the mongi ben hmida national institute of neurology in tunis, who had neurological manifestations related to VB12D. Among them, we selected those who presented with MD in order to analyze the phenomenology, imaging findings and clinical outcome.

Results: From a total of 70 patients with VB12D, 5 males were collected (7,1%) with a mean age of 59 years-old (between 43 and 75 years). MD described in these patients were: left upper limb chorea and truncal ataxia (1 case), generalized myoclonus and ataxia (1 case) and cerebellar ataxia (3 cases). Besides MD, 2 patients had proprioceptive symptoms, 2 had peripheral axonal neuropathy, 1 patient had nystagmus and 1 patient had pseudobulbar syndrome. The mean time to diagnosis was 20 months (between 7 days and 4 years). Brain imaging showed mild cerebellar atrophy in 3 patients and was normal in 2 patients. Vitamin B12 dosage was below 180 pg/ml in all patients and 2 had an atrophic gastropathy on gastric fibroscopy. Few weeks after an efficient vitamin B12 therapy, MD significantly improved in 4 patients.

Conclusion: MD similar to cerebellar ataxia, myoclonus and chorea can occur in adult patients with VB12D, mainly men. Yet, the pathogenic mechanism of such an association is not clear.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/movement-disorders-associated-with-vitamin-b12-deficiency-a-case-series/