West syndrome due to vitamin B12 deficiency

Abstract

Vitamin B-12 is one of the essential vitamins affecting various systems of the body. Vitamin B-12 deficiency in infants often produces haematological and neurological deficits including macrocyticanaemia, neurodevelopmental delay or regression, irritability, weakness, hypotonia, ataxia, apathy, tremor and seizures. In this article, we report the case of a 6-month-old male patient diagnosed with West syndrome associated with vitamin B-12 deficiency. Although the patient had no evidence of macrocytic anemia in complete blood count, we measured the level of vitamin B-12 because the patient had hypotonicity and found it to be low. No other problem was found in the other investigations directed to the etiology of West syndrome. He was being exclusively breast-fed and vitamin B-12 deficiency was related with nutritional inadequacy of his mother. Vitamin B-12 deficiency should be considered in the differential diagnosis of patients presenting with different neurological findings. Inaddition, vitamin B-12 deficiency should be considered as a rare cause in West syndrome which has a heterogeneous etiology.