Vitamin B-12 Associated Neurological Diseases Treatment & Management

  • Author: Niranjan N Singh, MD, DNB; Chief Editor: Selim R Benbadis, MD   more...
 
Updated: Feb 18, 2010
 

Medical Care

  • Establish the diagnosis and etiology of vitamin B-12 deficiency and treat with adequate doses.[22]
  • The consequences of vitamin B-12 deficiency, encephalopathy, myelopathy, and peripheral and optic neuropathy require adequate medical care.
  • Physical therapy and occupational therapy are needed to improve gait, balance, and arm function. Patients may require canes or a walker for ambulation and safety.
  • In patients with encephalopathy, neuropsychological interventions may improve cognition, social functioning, and interpersonal relationships.
  • Patients with PA are at increased risk for gastric carcinoma, colorectal adenocarcinoma, and carcinoid tumors and must be monitored.
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Consultations

Consultations with a gastroenterologist, a hematologist, and a neurologist must be considered.

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Diet

When the cause of vitamin B-12 deficiency is low intake, recommend that patients eat food that contains vitamin B-12 such as meat, eggs, cheese, and yogurt. Supplementation is required when religious or cultural restrictions render dietary changes impossible.

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Activity

In most patients with vitamin B-12–associated neuropathy/myelopathy, no restriction on physical activity is necessary unless weakness or gait ataxia is severe. Also, severe encephalopathy may lead to 24-hour supervision. In severe anemia or congestive heart failure, the patient should limit strenuous exercise.

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Contributor Information and Disclosures
Author

Niranjan N Singh, MD, DNB  Assistant Professor of Neurology, University of Missouri Columbia

Niranjan N Singh, MD, DNB is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Coauthor(s)

Florian P Thomas, MD, MA, PhD, Drmed  Director, Spinal Cord Injury Unit, St Louis Veterans Affairs Medical Center; Director, National MS Society Multiple Sclerosis Center; Director, Neuropathy Association Center of Excellence, Professor, Department of Neurology and Psychiatry, Associate Professor, Institute for Molecular Virology, and Department of Molecular Microbiology and Immunology, St Louis University School of Medicine

Florian P Thomas, MD, MA, PhD, Drmed is a member of the following medical societies: American Academy of Neurology, American Neurological Association, American Paraplegia Society, Consortium of Multiple Sclerosis Centers, and National Multiple Sclerosis Society

Disclosure: Nothing to disclose.

Alan L Diamond, DO  Movement Disorder Fellow, Department of Neurology, Baylor College of Medicine

Alan L Diamond, DO is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Osteopathic Association, and American Society of Neuroimaging

Disclosure: Nothing to disclose.

René Diamond, DO  Resident, Internal Medicine, Saint Louis University School of Medicine

René Diamond, DO is a member of the following medical societies: American Medical Student Association/Foundation and American Osteopathic Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Christopher Luzzio, MD  Clinical Assistant Professor, Department of Neurology, University of Wisconsin at Madison

Christopher Luzzio, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Nestor Galvez-Jimenez, MD, MSc, MHA  Chairman, Department of Neurology, Program Director, Movement Disorders, Department of Neurology, Division of Medicine, Cleveland Clinic Florida

Nestor Galvez-Jimenez, MD, MSc, MHA is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society

Disclosure: Nothing to disclose.

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Ortho McNeil Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Speaking, consulting

Chief Editor

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Ortho McNeil Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Speaking, consulting

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