Serial nerve conduction studies in vitamin B12 deficiency-associated polyneuropathy
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Chi-Ren Huang • Wen-Neng Chang • Nai-Wen Tsai • Cheng-Hsien Lu
- چاپ و سال / کشور: 2010
Description
polyneuropathy secondary to vitamin B12 deficiency. He presented with weakness and numbness of the distal limbs and absent deep tendon reflex in all four extremities. Nerve conduction study (NCS) showed an axonal type sensori-motor polyneuropathy. Serum biochemical studies revealed vitamin B12 level of 119 pg/mL (reference range 185–710 pg/mL), with elevated creatine kinase (CK) (719 U/L) and homocysteine (Hcy) (24.04 lmol/L) levels. Anti-parietal cell antibody test was positive. The patient received both oral and intramuscular injection of vitamin B12. The amplitude of the median and ulnar motor NCS increased 2.5 months later, while muscle power of the ankle plantar flexion and dorsiflexion recovered after 3.5 and 5.5 months, respectively. Follow-up NCS after 14.5 months showed response in sural NCS, but not the peroneal NCS. Follow-up also showed decreased serum Hcy and CK to 9.6 lmol/L and 198 U/L, respectively, and increasing amplitude of response. Recovery sequence involved muscle power of the proximal muscles, hands, plantar flexion, and dorsiflexion of the feet, and followed by sensory conduction.
Neurol Sci (2011) 32:183–186 DOI 10.1007/s10072-010-0428-9 Received: 25 June 2009 / Accepted: 9 September 2010 / Published online: 2 October 2010
