Catatonia and other psychiatric symptoms with vitamin B₁₂ deficiency

Abstract

Objective: To study unusual psychiatric manifestation of vitamin B12 deficiency and related issues.Method: A case study of 52‐year‐old female and review of relevant literature.Results: Complete remission of psychiatric symptoms without recurrence for the next 4 years with vitamin B12 as the only specific therapy instituted.Conclusion: Importance of B12 estimation and replacement in patients with varied psychiatric manifestations.

Vitamine–B12–deficiency causing isolated and partially reversible leukoencephalopathy

“…Furthermore, it underlines that early cobalamine substitution therapy can improve clinical outcome as well as MRI findings, which raises the question if remyelinisation could be responsible for the reduction of MRI lesions and clinical findings after initiation of treatment. The case also stresses, as already suggested by others [10][11][12], that chronic cobalamine deficiency can lead to psychiatric disease that may precede neurological symptoms.…”

Pernicious anemia presenting as catatonia: correlating vitamin B12 levels and catatonic symptoms

“…To date, three cases of vitamin B12 deficiency presenting as catatonia have been reported, one during pernicious anemia (with a vitamin B12 level of 159 pg/ml) and two others due to dietary intake deficiencies (1.07 and 150 pg/ml) [6][7][8]. This woman's case of pernicious anemia presenting as catatonia without signs of anemia or macrocytosis adds to the existing data a clinical-biological parallelism between catatonic symptoms and B12 levels over time.…”

“…Although the B12 levels were not very low -and although the normal range remains quite unclear, as most authors agree on 200 pg/ml as the lower limit -the B12 deficiency was confirmed [4]. Indeed, psychiatric symptoms can precede the onset of anemia or neurological features and can sometimes be seen in the absence of macrocytosis and while levels of B12 are not dramatically low [5,6].…”

Vitamin B12 Levels and Psychiatric Symptomatology: A Case Series

“…Also, in a few of the patients, B 12 levels were in the lower limit of the normal range, lending credence to earlier reports suggesting that psychiatric manifestations often predate the neurological symptoms, at times by as much as a few years. 11 Also, psychiatric manifestations can occur before the levels of vitamin B 12 are below 175 pg/L, and it has been proposed that the threshold needs to be increased to 660 pg/L. 11 Studies also mention a "window period" within which treatment may reverse changes, after which axonal demyelination and other pathological changes may be irreversible.…”