PT  - JOURNAL ARTICLE
AU  - Bruno Silva
AU  - Ana Velosa
AU  - J Bernardo Barahona-Corrêa
TI  - Reversible dementia, psychotic symptoms and epilepsy in a patient with vitamin B<sub>12</sub> deficiency
AID  - 10.1136/bcr-2018-229044
DP  - 2019 May 14
TA  - BMJ Case Reports
PG  - e229044
VI  - 12
IP  - 5
4099  - http://casereports.bmj.com/content/12/5/e229044.short
4100  - http://casereports.bmj.com/content/12/5/e229044.full
SO  - BMJ Case Reports2019 May 14; 12
AB  - 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.