Vitamin B-12 Associated Neurological Diseases Treatment & Management

Updated: Oct 22, 2018
  • Author: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM; Chief Editor: Selim R Benbadis, MD  more...
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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.



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



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.



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.