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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.
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