Ivan Martinka, Peter Špalek, Viera Hančinová, František Cibulčík, František Jurčaga, Ján Benetin
Vitamin B12 plays an important role in organism as cofactor of important enzymes of intermediary metabolism. Lack of vitamin B12 is caused by malabsorption in the gastrointestinal tract, insufficient nourishment by food or genetic deficiency of methylmalonyl-CoA mutase enzyme. Vitamin B12 deficiency usually presents with various haematological, neurological and psychiatric manifestations. Neurological manifestations include myelopathy, neuropathy and, rarely, optic nerve atrophy. Myelopathy in vitamin B12 deficiency presents as subacute combined degeneration of spinal cord (funicular myelosis), characterised by degeneration of the lateral and posterior columns. We report group of ten patients with deficiency of vitamin B12 and various neurological symptoms. In three patients the diagnosis of funicular myelosis was done, in 2 of them in combination with polyneuropathy. 6 patients had clinical and electrophysiological symptoms or signs characteristic for polyneuropatia. One patient had sexual dysfunction and problems with memory in combination with polyneuropathy. All of the patients were treated with intramuscular injections of cobalamin, the symptoms and signs have improved fully or at least partially.