Neuropediatrics 2015; 46 - WS12-02
DOI: 10.1055/s-0035-1550757

Connatal Nutritional Deficiency of Vitamin B12 in a Newborn with Early Neurologic Symptoms

V. Haug 1, D. Matheisl 1, S. Dittrich 1, C. Steinmetz 1
  • 1Zentrum für Kinder- und Jugendmedizin, Mainz, Germany

Case Study: Connatal nutritional deficiency of vitamin B12 in a newborn with early neurologic symptoms.

Case: The sixth child of a nonvegetarian German mother (GIX, PVI) and a Moroccan father, born in Germany with 36 + 5 weeks of gestation, birth weight 2,730 g, Apgar 9/10/10, NapH 7.38 was presented. Postnatal phototherapy. From birth on hyperexcitability in wakefulness, not in sleep. Breastfed newborn under triple antihypertensive therapy of the mother. Hospitalization at calculated delivery date. Lying on her back, she showed cloni and shivering of arms and legs, left more than right; sometimes facial myocloni.

We saw a megaloblastic anemia, which gave the hint toward a deficit of vitamin B12. Methylmalonic acid was slightly elevated as a typical sign of nutritive vitamin B12 deficit. Other examination as an MRI scan of the brain, cerebral fluid, etc., were normal. The EEG showed frontal and parietal spikes, not correlated with myocloni. After substitution of vitamin B12, the neurologic symptoms improved, even they did not resolve completely.

Discussion: A nutritive deficiency of vitamin B12 usually shows symptoms between 4 and 6 months of age. If the deficiency is because of intrauterine lack of vitamin B12, there might be neurological symptoms from birth. In our case, the high parity, the small amount of consumed meat, and the lack of substitution is probably the cause for the substantial deficiency.

Conclusion: Even in newborns of nonvegetarian mothers with neurological deficit connatal nutritional deficiency of vitamin B12 should be considered.

Keywords: vitamin b12, early neurological deficit.