{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T05:45:16Z","timestamp":1759383916772,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,5,1]]},"published-print":{"date-parts":[[2019,5,14]]},"abstract":"<jats:p>Vitamin B<jats:sub>12<\/jats:sub> 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\u2009years 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 B<jats:sub>12<\/jats:sub> deficiency found in the literature, symptom reversibility and the importance of its early recognition and treatment.<\/jats:p>","DOI":"10.1136\/bcr-2018-229044","type":"journal-article","created":{"date-parts":[[2019,5,15]],"date-time":"2019-05-15T06:25:28Z","timestamp":1557901528000},"page":"e229044","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Reversible dementia, psychotic symptoms and epilepsy in a patient with vitamin B<sub>12<\/sub> deficiency"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1839-7697","authenticated-orcid":false,"given":"Bruno","family":"Silva","sequence":"first","affiliation":[{"name":"Psychiatry, NOVA Medical School | Faculdade de Ci\u00eancias M\u00e9dicas de Lisboa and Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal"},{"name":"CADIN\u2013Neurodesenvolvimento e Inclus\u00e3o, Cascais, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Velosa","sequence":"additional","affiliation":[{"name":"Psychiatry, NOVA Medical School | Faculdade de Ci\u00eancias M\u00e9dicas de Lisboa and Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Bernardo","family":"Barahona-Corr\u00eaa","sequence":"additional","affiliation":[{"name":"Psychiatry, NOVA Medical School | Faculdade de Ci\u00eancias M\u00e9dicas de Lisboa and Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal"},{"name":"CADIN\u2013Neurodesenvolvimento e Inclus\u00e3o, Cascais, Portugal"},{"name":"Neuropsychiatry Unit, Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,5,14]]},"reference":[{"key":"2025082623503833000_12.5.e229044.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1113996"},{"key":"2025082623503833000_12.5.e229044.2","first-page":"317","article-title":"Cobalamin deficiency manifested with seizures, mood oscillations, psychotic features and reversible dementia in the absence of typical neurologic and hematologic signs and symptoms: a case report","volume":"37","author":"Vilibi\u0107","year":"2013","journal-title":"Coll Antropol"},{"key":"2025082623503833000_12.5.e229044.3","doi-asserted-by":"publisher","DOI":"10.1177\/0960327111422404"},{"key":"2025082623503833000_12.5.e229044.4","first-page":"122","article-title":"Recurrent seizures: an unusual manifestation of vitamin B12 deficiency","volume":"52","author":"Kumar","year":"2004","journal-title":"Neurol India"},{"key":"2025082623503833000_12.5.e229044.5","first-page":"395","article-title":"Psychiatric presentations of vitamin B 12 deficiency","volume":"105","author":"Bhat","year":"2007","journal-title":"J Indian Med Assoc"},{"key":"2025082623503833000_12.5.e229044.6","first-page":"303","article-title":"Psychiatric syndromes due to avitaminosis B12 with normal blood and marrow","volume":"34","author":"Strachan","year":"1965","journal-title":"QJM: An International Journal of Medicine"},{"key":"2025082623503833000_12.5.e229044.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198806303182604"},{"key":"2025082623503833000_12.5.e229044.8","doi-asserted-by":"publisher","DOI":"10.1016\/0014-2999(93)90925-8"},{"key":"2025082623503833000_12.5.e229044.9","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830340205"},{"key":"2025082623503833000_12.5.e229044.10","first-page":"447","article-title":"Recognition of deficiency of vitamin B12 using measurement of serum concentration","volume":"107","author":"Cooper","year":"1986","journal-title":"J Lab Clin Med"},{"key":"2025082623503833000_12.5.e229044.11","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90149-X"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-229044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:50:43Z","timestamp":1756277443000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-229044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,14]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5,14]]},"published-print":{"date-parts":[[2019,5,14]]}},"alternative-id":["10.1136\/bcr-2018-229044"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-229044","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,5,14]]}}}