Food and Behaviour Research

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Retardation of myelination due to dietary vitamin B12 deficiency: cranial MRI findings

Lovblad K, Ramelli G, Remonda L, Nirkko AC, Ozdoba C, Schroth G. (1997) Pediatr Radiol.  27(2) 155-8. 

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Vitamin B12 deficiency is known to be associated with signs of demyelination, usually in the spinal cord. Lack of vitamin B12 in the maternal diet during pregnancy has been shown to cause severe retardation of myelination in the nervous system.

We report the case of a 14(1)/2-month-old child of strictly vegetarian parents who presented with severe psychomotor retardation.

This severely hypotonic child had anemia due to insufficient maternal intake of vitamin B12 with associated megaloblastic anemia.

MRI of the brain revealed severe brain atrophy with signs of retarded myelination, the frontal and temporal lobes being most severely affected.

It was concluded that this myelination retardation was due to insufficient intake of vitamin B12 and vitamin B12 therapy was instituted. The patient responded well with improvement of clinical and imaging abnormalities.

We stress the importance of MRI in the diagnosis and follow-up of patients with suspected diseases of myelination.


Vitamin B12 can be obtained only from animal-derived foods, or by supplementation. Vegan diets therefore lead to deficiency unless the diet is adequately supplemented with B12.

Vitamin B12 deficiency during pregnancy and early life can have potentially devastating effects on infant health and development, particularly with respect to the brain and nervous system, as this case report illustrates.

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