Food and Behaviour Research

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Vitamin B12 deficiency presenting as acute ataxia.

Crawford JR, Say D. (2013) BMJ Case Rep.  Mar 26  

Web URL: View this and related abstracts via PubMed here


A previously healthy 7-year-old Caucasian boy was hospitalised for evaluation of acute ataxia and failure to thrive, initially suspicious for an intracranial mass.

Weight and body mass index were below the third percentile and he demonstrated loss of joint position and vibratory sense on examination. Laboratory studies revealed megaloblastic anaemia while an initial MRI of the brain showed no evidence of mass lesions or other abnormalities.

A dietary history revealed the child subscribed to a restrictive vegan diet with little to no intake of animal products or other fortified foods. The child was diagnosed with presumed vitamin B12 deficiency and was treated with intramuscular B12 injections.

Neurological symptoms resolved promptly within several days after starting therapy. This case underlines the importance of assessing nutritional status in the evaluation of neurological dysfunction in the pediatric patient.


Vegan diets lack Vitamin B12, which is vital for normal brain development and function (as well as for many other aspects of health and development)

Serious deficiencies of Vitamin B12 lead to neurological symptoms, as documented in this case of a 7 year old child, who was initially referred on suspicion of a possible brain tumour.

As the authors emphasise, consideration and assessment of nutrition and diet by pediatricians and other clinicians is warranted in any investigation of neurological or neurodevelopmental problems in children.

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