Vitamin B12 deficiency neuropathies

[Jen-Schiler]

    
      Re: Vitamin B12 deficiency neuropathies
    


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Posted by CCF Neurology MD(B) on March 20, 1998 at 11:08:01:

In Reply to: Vitamin B12 deficiency neuropathies posted by Jen Schiller on March 14, 1998 at 22:09:48:

: In October of 1996 I had a Roux-en-Y gastroplasty for weight reduction.  In August of 1997 I began experiencing tingling in my lower back, mostly in p.m., which continued over next several months.  In October of 1887 I noted an area of numbness in my lower back at site of tingling. About a week later I experienced some chills after being in a frigid room for half a day. Later that week I began feeling weak. At the time I saw Dr. reported primarily the tingling/numbness problem and also causually mentioned the chills/weakness.  Received blood test which showed pernicious anemia and was given a B12 shot. One day later I was hospitalized with leg paralysis, where leg painful to touch, and also became incontinent. My brain and spinal MRI's were negative for lesions, and my spinal tap was positive for elevated cells and proteins.  I was treated with Prednisone.  EMG showed diffuse conduction slowing and possible peripheral nerve lesions.

  My diagnoses have ranged from basic PN, to GBS variant, to mylopathy and postviralmyeloradiculopathy, to possible MS or CIDP.  Vitamin B12 deficiency neuropathy was discounted as a probable cause due to length of deficiency of slightly less than a year at time of first nuerologic sign (tingling in back)).  I would like a medical opinion if it is possible for my condition (mylopathy and myeloradiculoneuropathy to have been caused by the B12 deficiency?    By the way, upon admission to the ER, I had bilateral Babinski signs and preserved reflexes in the legs. I now walk fairly well with a single tip cane, in house w/o cane, but have continued tightness (spasicity) in legs.  I am just so frustrated at the range of diagnoses and am considering getting a second neurological opinion. I am on HIP, have a Cleveland Clinic in my area, but don't think  it's "in network".
= Dear J. Schiller, Based on the information you have given me, I am struck by the acuteness of your lower extremity weakness.  This would be more consistent with diseases such as GBS(top of the list), Transvers Myelitis, CIDP or MS than with a metabolic disorder such as Vit B-12 disorder.  I would recommend that you be evaluated by a neurologist who specializes in perheral nerve diseases.  While he may not be able to provide you with a single diagnosis (sometimes this is just not possible), he may be able to provide you with reassurance that the physicians evaluating and subsequently treating you did so properly based on the information they had at that time.  While you may not be able to be seen at the CCF secondary to insurance reasons, as an alternative you may wish to contact the neuromuscular division of the Department Of Neurology with a list of recommended neurologists from your insurance carrier. It may be possible that they could make a recommendation(s) from the names on the list.  Hope this helps.  "This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition."