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Vitamin B12 resolves shaky-leg syndrome

MADRID, SPAIN. Dr. Julian Benito-Leon MD, a physician at the Hospital General de Mostoles, reports the case of a 68-year-old man with the shaky-leg syndrome. The shaking (tremor) would begin immediately after the patient stood up and subside as soon as he began walking. A detailed examination revealed that the patient had a very low blood level of vitamin B12 (132 ng/L versus normal range of 222 to 753 ng/L) and a Schilling test demonstrated malabsorption of vitamin B12. The patient was put on the anticonvulsant clonazepam (1 mg/day) and was given vitamin B12 injections (1 mg daily for two weeks, then weekly for two months, and once a month thereafter). This treatment completely eliminated the tremor. After one year clonazepam was discontinued without reoccurrence of the shaky-leg syndrome. Dr. Benito-Leon and his colleagues conclude that the problem was a result of disturbances in the cerebellum or related brain structures caused by a vitamin B12 deficiency. They believe that the vitamin B12 injections were responsible for resolving it.
Benito-Leon, Julian and Porta-Etessam, Jesus. Shaky-leg syndrome and vitamin B12 deficiency. New England Journal of Medicine, Vol. 342, No. 13, 2000, p. 981 (correspondence)

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