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Reversible dementia, psychotic symptoms and epilepsy in a patient with vitamin B12 deficiency
  1. Bruno Silva1,2,
  2. Ana Velosa1 and
  3. J Bernardo Barahona-Corrêa1,2,3
  1. 1 Psychiatry, NOVA Medical School | Faculdade de Ciências Médicas de Lisboa and Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
  2. 2 CADIN–Neurodesenvolvimento e Inclusão, Cascais, Portugal
  3. 3 Neuropsychiatry Unit, Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
  1. Correspondence to Prof. J Bernardo Barahona-Corrêa, bernardo.correa{at}


Vitamin B12 deficiency is a common condition, typically associated with megaloblastic anaemia, glossitis and neuropsychiatric symptoms. We report the case of a patient presenting with progressive cognitive and functional deterioration, psychosis and seizures, later found to be secondary to pernicious anaemia. Importantly, the diagnosis of pernicious anaemia was only established 5 years after symptom onset and was overlooked even when the patient was under medical care, in part due to the lack of classic neurological and haematological signs associated with the condition. The patient had a remarkable neuropsychiatric recovery after vitamin replacement and psychopharmacological management. We discuss similar presentations of vitamin B12 deficiency found in the literature, symptom reversibility and the importance of its early recognition and treatment.

  • pernicious anemia
  • psychotic disorders (incl schizophrenia)
  • epilepsy and seizures
  • memory disorders

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  • Contributors All authors were involved in the clinical management of this patient. BS and AV wrote the initial manuscript, that was reviewed and corrected by JBBC. All authors made significant intellectual contributions to the case discussion.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.