CEREBROSPINAL-FLUID METHYLMALONIC ACID CONCENTRATIONS IN NEUROLOGICALPATIENTS WITH LOW AND NORMAL SERUM COBALAMIN CONCENTRATIONS

Objective - To determine whether cerebrospinal fluid (CSF) methylmalon ic acid (MMA) is increased in neurological patients with low serum cob alamin (Cbl, vitamin B-12) concentrations as opposed to neurological p atients with normal serum Cbl concentrations. Material and methods - W e measured MMA concentrations in serum and CSF of neurological patient s with low serum cobalamin concentrations, but without overt cobalamin related manifestations such as anemia or combined disease of the cord , and neurological patients with normal serum cobalamin concentrations (controls). Results - Serum and CSF MMA concentrations were significa ntly higher in patients than in controls. Serum MMA was elevated in 4 patients of whom 3 had clearly elevated CSF MMA concentrations. Conclu sion - Strong indications for cobalamin deficiency can be found not on ly in serum but also in CSF of patients with seemingly asymptomatic lo w serum cobalamin concentrations. (C) Munksgaard 1998.