ビタミン欠乏性神経疾患の診断と治療

抄録

Vitamin B deficiency causes various neurological disorders, including encephalopathy (acute and chronic), myelopathy, neuropathy, and optic neuropathy. Vitamin B1 deficiency causes Wernicke's encephalopathy (characterized by consciousness disturbance/memory disturbance, eye signs, and cerebellar ataxia), polyneuropathy, and optic neuropathy. Vitamin B3 deficiency causes pellagra (characterized by dementia, dermatitis, and diarrhea). Vitamin B12 deficiency causes dementia, subacute combined degeneration, polyneuropathy, and optic neuropathy. Additionally, vitamin B12 deficiency causes thrombosis because of hyperhomocysteinemia. Early diagnosis of neurological disorders owing to vitamin deficiency is not straightforward, specifically in atypical cases. Therefore, neurological signs/symptoms in patients at high risk of vitamin deficiency, such as those with alcohol use disorders, vegetarians, or post–gastrectomy should be immediately treated with a large dose of multiple B vitamins.