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Handb Clin Neurol. 2014;120:915-26. doi: 10.1016/B978-0-7020-4087-0.00060-7.

Neurologic aspects of cobalamin (B12) deficiency.

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Department of Neurology, Mayo Clinic, Rochester, MN, USA. Electronic address:


Optimal functioning of the central and peripheral nervous system is dependent on a constant supply of appropriate nutrients. Particularly important for optimal functioning of the nervous system is cobalamin (vitamin B12). Cobalamin deficiency is particularly common in the elderly and after gastric surgery. Many patients with clinically expressed cobalamin deficiency have intrinsic factor-related malabsorption such as that seen in pernicious anemia. The commonly recognized neurological manifestations of cobalamin deficiency include a myelopathy with or without an associated neuropathy. This review deals with neurological aspects of vitamin B12 deficiency and attempts to highlight recent developments.


Nutrition; cobalamin deficiency; myelopathy; neurology; pernicious anemia

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