Reversible dementia, psychotic symptoms and epilepsy in a patient with vitamin Bdeficiency.
BMJ Case Rep. 2019 May 14 ;12(5). Epub 2019 May 14. PMID: 31092496
Vitamin Bdeficiency 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 Bdeficiency found in the literature, symptom reversibility and the importance of its early recognition and treatment.