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Association With Neurological Dysfunction

Karl D. Kieburtz, MD; Daniel W. Giang, MD; Randolph B. Schiffer, MD; Nimish Vakil, MD

Arch Neurol. 1991;48(3):312-314.

Abstract
• An increased prevalence of vitamin B₁₂ deficiency has been reported in patients infected by the human immunodeficiency virus (HIV). We report an unexpectedly high prevalence (20%) of such abnormal vitamin B₁₂ metabolism in a population of HIV-infected patients referred for neurological evaluation. This abnormality was associated with both peripheral neuropathy and myelopathy. A majority of those treated with cyanocobalamin had a therapeutic response. Selected neuropathological results suggest a relationship between vitamin B₁₂ deficiency and vacuolar myelopathy. Vitamin B₁₂ deficiency may be a frequent and treatable cause of neurological dysfunction in patients with HIV infection.

Author Affiliations
From the Departments of Neurology (Drs Kieburtz, Giang, and Schiffer) and Internal Medicine (Gastroenterology) (Dr Vakil), University of Rochester (NY) School of Medicine.

Footnotes
Accepted for publication September 5, 1990.

Reprint requests to Box 673, Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642 (Dr Kieburtz).

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