Epileptic spasms and partial seizures associated with vitamin B12 deficiency: case report and literature review

Epileptic spasms associated with vitamin B12 deficiency are rare. Epileptic spasms in addition to partial seizures due to vitamin B12 deficiency have never been reported in the literature. A 31/2-month-old girl presented to clinic with partial seizures and epileptic spasms. An extensive workup for metabolic disorders and a 3 Tesla magnetic resonance imaging (MRI) of brain were normal. However, the exclusively breast-fed infant and her mother had low vitamin B12 levels, so both were given intramuscular (IM) vitamin B12 injections. The infant was also treated with oral vigabatrin and IM adrenocorticotrophic hormone (ACTH) injections. Patient's seizures stopped; however, developmental delay and hypotonia remained. Seizures associated with vitamin B12 deficiency in infants are rare, but vitamin B12 level should always be checked as part of routine diagnostic workup.