Neurological Manifestations in Vitamin B12 Deficient Children: A Prospective Observational Study

Abstract

Background and aim: Neurological manifestations in vitamin B12 deficient children in common. The present study determined neurological manifestations in vitamin B12 deficient children in a tertiary care centre in Rajasthan.

Methods: This hospital based observational analytical study was conducted in Department of Pediatrics, Dr. S. N. Medical College, Jodhpur after approval of Institutional Ethics Committee (IEC). The study population included Vitamin B12 deficient (<250 picogram/dl) children during September 2019 to August 2020. All children aged 6 months to 5 years admitted in pediatric ward with anaemia (Hb< 11 gm/dl according to WHO Criteria) were screened for serum vitamin B12 levels out of which children having serum vitamin B12 level <250Pg/dl were included in the study. Results: More than half (63.8%) of the children aged between 6 months and 15 months. Male to female ratio was 1.58:1. 78.7% were rural and 60% were from lower socioeconomic class. 85% of the children’ family had vegetarian dietary habits. The most common clinical feature was hyperpigmentation of knuckles and skin (85% each) followed by depigmented and sparse hair (70%), and chubby face (42.5%). 65% of the children were found to have neurological manifestations. The most common neurological manifestation was developmental delay (60%) followed by hypotonia (38.7%), exaggerated reflexes (31.2%), and abnormal movements (20%). Conclusion: There is an urgent demand for early evaluation of the children so prevent further prevent developmental growth of the children.

Keywords: Neurological manifestations, vitamin B12, developmental delay