Hyperkinetic movements due to Borderline Vitamin B12.

Abstract

This case report discusses a 27-year-old adult female patient who presented with hyperkinetic involuntary movements, which remained underdiagnosed for several years. She proved refractory to various treatments until experiencing a significant improvement after receiving parenteral administration of vitamin B12. The patient had an eight-year history of “tremors,” predominantly in the upper limbs, and was diagnosed with chorea by a neurologist in her hometown. Her hyperkinetic movements adversely affected her daily activities. She also exhibited neurological signs associated with vitamin B12 deficiency, such as hypoesthesia in the lower limbs, diminished reflexes, and ataxia. Previous laboratory tests revealed low levels of vitamin B12 (248 pg/mL). Initially, there was suspicion of Neuromyelitis Optica, but tests did not confirm this condition. Following parenteral vitamin B12 treatment, her B12 levels increased to 877 pg/mL, resulting in a reduction of involuntary movements and a significant improvement in her overall condition. Vitamin B12 deficiency can lead to movement disorders,  and vitamin B12 therapy is effective in reversing these symptoms.