White matter disorder due to vitamin B12 deficiency

Description

Neurological features occur in 40% of patients with B12 deficiency. Subacute combined degeneration is a potentially reversible neurological complication of a vitamin B12 deficiency. Symptoms develop insidiously and neuropathic manifestations include progressive paraesthesia distally, numbness, gait ataxia and diminished proprioception in the lower limbs, while the myelopathic component leads to variable motor impairment due to pyramidal tract dysfunction. Incontinence of bowel and bladder with impotence and postural hypotension occur as part of the myelopathy. Central manifestations include confusion, depression, progressive hallucination and mental slowing. There may also be optic neuropathy present.

Exclusions from above levels

• 05 – Endocrine, nutritional or metabolic diseases
• 18 – Complications of pregnancy, childbirth and the puerperium
• 19 – Certain conditions originating in the perinatal period