PT  - JOURNAL ARTICLE
AU  - Sumant Biyani
AU  - Sneh Kumar Jha
AU  - Suchit Pandey
AU  - Rakesh Shukla
TI  - Acute bilateral useless hand syndrome: a rare presenting manifestation of vitamin B<sub>12</sub> deficiency
AID  - 10.1136/bcr-2015-210067
DP  - 2015 Oct 16
TA  - BMJ Case Reports
PG  - bcr2015210067
VI  - 2015
4099  - http://casereports.bmj.com/content/2015/bcr-2015-210067.short
4100  - http://casereports.bmj.com/content/2015/bcr-2015-210067.full
AB  - We report a case of bilateral useless hand syndrome, a rare presenting manifestation of vitamin B12 deficiency. A 38-year-old man, a strict vegetarian and a teacher by occupation, presented with acute onset clumsiness of both hands while performing fine movements. Detailed history-taking, examination of the patient and relevant investigations (complete blood count, serum vitamin B12 and MRI of the cervical spinal cord) were carried out. Laboratory analysis was suggestive of vitamin B12 deficiency and MRI demonstrated a lesion involving the posterior columns of the cervical cord. The patient was diagnosed as a case of non-compressive cervical myelopathy predominantly involving the posterior column due to vitamin B12 deficiency. Acute bilateral useless hand syndrome can be a rare presenting feature of vitamin B12 deficiency.