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Vitamin B12 deficiency: an unusual cause of vocal fold palsy

Published online by Cambridge University Press:  27 July 2011

R Green ,
N Kara  and
H Cocks
R Green*
Affiliation:
ENT Department, Sunderland Royal Hospital, Tyne and Wear, UK
N Kara
Affiliation:
ENT Department, Sunderland Royal Hospital, Tyne and Wear, UK
H Cocks
Affiliation:
ENT Department, Sunderland Royal Hospital, Tyne and Wear, UK
*
Address for correspondence: Dr Richard Green, ENT Department, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK E-mail: [email protected]
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Abstract

Objective:

We report an extremely rare case of vocal fold palsy secondary to vitamin B12 deficiency.

Method:

Case report and English-Language review of the world literature concerning vitamin B12 deficiency and its neurological manifestations. We discuss the physiological role of vitamin B and its specific relationship to the presented patient's symptoms.

Results:

We describe a rare instance of a patient presenting with bilateral lower limb weakness and unilateral vocal fold palsy, as a manifestation of vitamin B12 deficiency. Quick recognition and treatment resulted in a full recovery.

Discussion:

To our knowledge, this is the first reported case of unilateral vocal fold palsy secondary to vitamin B12 deficiency. Central and peripheral neuropathies have been described; however, other than the optic nerve, the cranial nerves are very rarely affected. It is important to consider vitamin B12 deficiency as a cause, as speedy identification and treatment can help prevent permanent neurological damage.

Keywords

LarynxVocal Cord ParalysisVitamin B12
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 12 , December 2011 , pp. 1309 - 1311
Copyright
Copyright © JLO (1984) Limited 2011

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Footnotes

Presented as a poster at the North of England ENT Meeting, 25 September 2009, Sunderland, UK

References

1Wang, YH, Yan, F, Zhang, WB, Ye, G, Zheng, YY, Zang, XH et al. An investigation of vitamin B12 deficiency in elderly inpatients in neurology department. Neurosci Bull 2009;25:209–15CrossRefGoogle ScholarPubMed
2Locatelli, ER, Laureno, R, Ballard, P, Mark, AS. MRI in vitamin B12 deficiency myelopathy. Can J Neurol Sci 1999;26:60–3Google ScholarPubMed
3Pittock, SJ, Payne, TA, Harper, CM. Reversible myelopathy in a 34-year-old man with vitamin B12 deficiency. Mayo Clin Proc 2002;77:291–4CrossRefGoogle Scholar
4Puntambekar, P, Basha, M, Zak, I, Madhavan, R. Rare sensory and autonomic disturbances associated with vitamin B12 deficiency. J Neurol Sci 2009;287:285–7CrossRefGoogle ScholarPubMed
5Shorvon, SD, Carney, MW, Chanarin, I, Reynolds, EH. The neuropsychiatry of megaloblastic anemia. BMJ 1980;281:1036–8CrossRefGoogle Scholar
6Clarke, R, Grimley, EJ, Schneede, J, Nexo, E, Bates, C, Fletcher, A et al. Vitamin B12 and folate deficiency in later life. Age Ageing 2004;33:34–41CrossRefGoogle ScholarPubMed
7Reynolds, E. Vitamin B12, folic acid, and the nervous system. Lancet 2006;5:949–60CrossRefGoogle ScholarPubMed
8Moretti, R, Torre, P, Antonello, RM, Cattaruzza, T, Cazzato, G, Brava, A. Vitamin B12 and folate depletion in cognition: a review. Neurol India 2004;52:310–18Google ScholarPubMed
9Bjorkegren, K, Svardsudd, K. Reported symptoms and clinical findings in relation to serum cobalamin, folate, methylmalonic acid and total homocysteine among elderly Swedes: a population-based study. J Intern Med 2003;254:343–52CrossRefGoogle ScholarPubMed
10Victor, M, Ropper, AH. Diseases of the nervous system due to nutritional deficiency. In: Victor, M, Ropper, AH, eds. Adams and Victor's Principles of Neurology, 7th edn.New York: McGraw-Hill, 2001;1218–23Google Scholar
11Ahn, T-B, Cho, J-W, Jeon, BS. Unusual neurological presentations of vitamin B12 deficiency. Eur J Neurol 2004;11:339–41CrossRefGoogle Scholar
12Puri, V, Chaudhry, N, Goel, S, Gulati, P, Nehru, R, Chowdhury, D. Vitamin B12 deficiency: a clinical and electrophysiological profile. Electromyogr Clin Neurophysiol 2005;43:273–84Google Scholar
13Richardson, BE, Bastian, RW. Clinical evaluation of vocal fold paralysis. Otolaryngol Clin North Am 2004;37:45–58CrossRefGoogle ScholarPubMed