Vitamin B12 deficiency in exclusively breastfed infants is an important problem in developing countries. Vitamin B12 deficiency is associated with a wide spectrum of clinical manifestations. Few cases of vitamin B12 deficiency have been reported as the cause of infantile spasms. We report the case of a 6-month-old boy diagnosed with infantile spasms associated with vitamin B12 deficiency caused by nutritional inadequacy in the mother. He was observed to have head nods and flexor limbs spasms which appeared in clusters. Psychomotor development was normal. The serum vitamin B12 level was low and results of electroencephalography (EEG) indicated modified hypsarrhythmia. His symptoms resolved after synthetic adrenocorticotropic hormone (ACTH) and vitamin B12 treatment. The EEG was completely normal after the first month and sixth month of treatment. In addition to ACTH and vitamin B12 treatment, following antiepileptic drug treatment was not initiated. During 21 months’ follow up he is seizure-free and his neurological development is age-appropriate. This case of a 6 month-old infant with infantile spasms due to vitamin B12 deficiency seems to be a striking because of only with vitamin B12 and ACTH treatment the patient became seizure-free. Vitamin B12 deficiency may be a treatable cause of infantile spasms and should be considered in the associated cause of infantile spasms especially if nutritional inadequacy in the mother.
Vitamin B 12 Deficiency ; Infants