Vitamin B-12 Associated Neurological Diseases Treatment & Management

Updated: Aug 04, 2016
  • Author: Niranjan N Singh, MD, DM; Chief Editor: Selim R Benbadis, MD  more...
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Treatment

Medical Care

See the list below:

  • Establish the diagnosis and etiology of vitamin B-12 deficiency and treat with adequate doses. [27]
  • 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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