Dg. Savage et J. Lindenbaum, NEUROLOGICAL COMPLICATIONS OF ACQUIRED COBALAMIN DEFICIENCY - CLINICAL ASPECTS, Bailliere's clinical haematology, 8(3), 1995, pp. 657-678
Cobalamin (Cbl, vitamin B-12) deficiency of the nervous system is a ch
ronic progressive disorder characterized by abnormalities of the spina
l cord, peripheral nerves, optic nerves and cerebrum. Initial reports
of the nervous system disorder in the late nineteenth and early twenti
eth centuries emphasized severe spinal cord disease (Lichtheim, 1887;
Russell et al, 1900). Later authors attributed the neurological featur
es to peripheral neuropathy (Hamilton and Nixon, 1921; Pallis and Lewi
s, 1974). Most patients appear to have features consistent with both m
yelopathy and peripheral neuropathy (Healton et al, 1991). In this rev
iew we will use the term 'Cbl neuropathy' to refer to the neurological
complications of Cbl deficiency, including spinal cord, peripheral ne
rve and cerebral damage. We believe that Cbl neuropathy better encompa
sses the diverse manifestations of Cbl deficiency than other terms, su
ch as 'combined systems disease' and 'subacute combined degeneration'.