BMJ Case Reports 2012; doi:10.1136/bcr-03-2012-6138
  • Unusual association of diseases/symptoms

Unusual association of Arnold-Chiari malformation and vitamin B12 deficiency

  1. Heramba Narayan Praharaj
  1. Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India
  1. Correspondence to Professor Rajesh Verma, drrajeshverma32{at}
  1. Competing interests None.

Arnold-Chiari malformations are a group of congenital or acquired defects associated with the displacement of cerebellar tonsils into the spinal canal. First described by Chiari (1891), this has various grades of severity and involves various parts of neuraxis, for example, cerebellum and its outputs, neuro-otological system, lower cranial nerves, spinal sensory and motor pathways. The symptomatology of Arnold-Chiari malformations may mimic multiple sclerosis, primary headache syndromes, spinal tumours and benign intracranial hypertension. We highlighted a case of Chiari type I malformation, who presented with posterolateral ataxia associated with significant vitamin B12 deficiency. The patient was supplemented with vitamin B12 injections and showed remarkable improvement at follow-up after 3 months.


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