Guillain Barre or vitamin B12 deficiency and PN?

[Jen-Schiler]

    
      Re: Guillain Barre or vitamin B12 deficiency and PN?
    


[ Follow Ups ] [ Post Followup ] [ Neurology and Neurosurgery Forum ] [ FAQ ]



Posted by CCF Neurology LG on March 01, 1998 at 02:47:38:

In Reply to: Guillain Barre or vitamin B12 deficiency and PN? posted by Jen Schiller on February 28, 1998 at 23:03:36:

: Info I have been picking up from Internet Peripheral Neuropathy and Guillain Barre sites have me confused as does my nuerologists diagnosis.  
  In October 1996 I had a Roux-en-Y gastroplasty surgery (stomach stapling and small intestine resection) done for weight reduction.  In August of '97 I noted tingling sensations in my lower back, particularly in p.m.  Internist said it was probably a "pinched nerve".  Tingling continued and in October '97 also noted area of numbness in lower back. Dermatologist suggested neurology consult.  Saw internist again, also complaining of chills  (no fever) and general weakness as well as the increased tingling in lower back.  Got blood test which showed pernicious anemia.  Internist suspected B12 deficiency because of gastroplasty. Gave me B12 vitamin injection.  
  Two days later I was hospitalized with total leg paralysis progresing to lower back, slight tingling in hands and lips, and slightly blurred vision.  Neurologists labeled condition "peripheral neuropathy" but not sure if Guillain Barre or vitamin B12 deficiency.  Primary neurologist said cannot be B12 deficiency because it takes years to produce neuropathy.  Chills I experienced could have been viral infection.  Hopwever, I was treated with Prednisone, which is NOT indicated in treatment of GBS!  Three months after hospitalization am recovering, walking with cane, have residual numbness and tightness at knees and lower thighs, still tingling in hands and lips, vision OK, burning (no pain) bottom of feet. Neurologist says that means my nerves are coming back.  I'm taking Trinsicon (intrinsic factor, B12,  folic acid, iron), B1, etc. However, I still don't know if my PN is Guillain Barre or cause by Vitamin B12 deficiency.  Can a B12 deficiency of slightly less than a year (since gastroplasty) cause PN?
Dear Jen,
First let me start by giving you a brief summary of GBS and B12 deficiency.  GBS results in one type of peripheral neuropathy.  In 60% of cases it is preceded by a mild respiratory of GI infection.  These symptoms are followed in 1-2 weeks by paresthesias (numbness and tingling).  Over the next few days to 1-2 weeks weakness develops in the legs and spreads to the arms.  If severe the cranial nerves and respiratory status may be involved.  There may be aching in the hips and back.  One striking feature of this disorder is loss of all reflexes.  In general, most people recover completely over the next several months; about 10% are left with residual disability.  On the other hand, B12 (cobalamin) deficiency first starts out with paresthesias involving the hands more that the feet.  As the symptoms progress, walking becomes unsteady, weakness occurs, and a stiffness (spasticity) develops in the legs.  The disorder tends to progress slowly with increased sensory findings (loss of vibration and joint position) and ataxia (difficuly with coordination).   In addition, there may be come confusion and visual impairment.  From what you described your acute symptoms sound like GBS.  Your B12 may have played a minor role,if any, in your general symptoms but at least you are on therapy now.  I hoped this helped. Good Luck.