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Vitamin b12 deficiency mimics parkinsons?
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pdhelp posted:
Hi Dr Stacy

I have read at many sites that vitamin b12 deficiency symptoms closely mimic parkinsons. can fine postural tremor and numbess in the limb extremeties be caused by vit b12 deficiency?

also my dad has been diagnosed with mild adiadochokinesia. does that constitute to be bradykinesia?

Thanks
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susiemargaret responded:
hello, P --

yes, postural tremor (see PS1) and numbness can be caused by a vitamin B-12 deficiency. furthermore, parkinson's disease is usually characterized by a resting tremor, not a postural one. however, both postural and resting tremors, and numbness, can be caused by many things other than a vitamin B-12 deficiency or parkinson's disease.

adiadochokinesia is the inability to make rapidly alternating muscular movements of the arm or leg, such as bending and straightening a hand. bradykinesia is an abnormal slowness of movement. i am not a medical person (PS2), but it seems to me that these are opposites.

-- susie margaret

PS1 -- a postural tremor is one that occurs when a person is holding an arm or leg "against gravity," such as stretched out in front of him/her.

PS2 -- i welcome, solicit, and indeed beg for correction, amendment, or replacement of inaccuracies in this post.
what good is gold, or silver too, if your heart's not good and true -- hank williams, sr.
 
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susiemargaret responded:
hello, P and everyone else --

humility alert! humility alert! humility alert!

i must have stayed up too late last night, because i am re-reading my response and realize that it came out terribly garbled. my definitions for adiadochokinesia and for bradykinesia are right, but the contrast i drew was exactly the opposite of what it should have been; in other words, i said there was a speed contrast between them but there isn't one (see PS). in addition, i think i should have focused on the structure of the movements involved as well as their speed.

i am so sorry, and i'll try to correct this, but if i still get it wrong or incomprehensible, i hope that dr. stacy or anyone who is more knowledgeable than i am (meaning, practically everybody in the known universe!) will jump in and say, "no, no, she's got it all wrong again, here's what she should have said." i won't be offended, believe me, i'll be relieved that the correct comparison was made.

adiadochokinesia concerns the inability to make movements that are alternating and rapid, with one significant Q being whether they can alternate -- flipping a hand up and down at the wrist, or extending a foot downward and then raising it up at the ankle, etc., etc. adiadochokinesia also includes the idea that those movements cannot be made rapidly. in other words, adiadochokinesia equals can't make movements that alternate and/or can't make fast movements even if they can alternate.

bradykinesia concerns speed only, or, rather, lack of speed. any movements, no matter what they look like or are supposed to look like, are slow. this includes alternating movements, straight-line movements, curled-up movements, whatever. the correct concept, then, is that adiadochokinesia can always be considered a kind of bradykinesia, but not the other way around. exactly what you said! i feel like such a dope!

if you're still having trouble deciphering what i'm trying to say, would you be willing to re-post your inquiry, with dr. stacy's name in the title, such as "dr. stacy, vitamin B-12 deficiency mimics parkinson's?" that way it will be more likely to catch his attention and i can slink off into the darkness unnoticed, trailing apologies and mortification in my wake.

i hate that i got this wrong and hope that you won't hold it against webMD, because i am not a staff person, i'm just a volunteer who responds to a lot of the community Qs. if you are annoyed, which you have every right to be, i am the proper target, not webMD.

moral of the story, for me, anyway -- no more staying up late and trying to think at the same time.

-- susie margaret

PS -- adiadochokinesia = inability for rapid movement, therefore movement is slow. bradykinesia = movement is slow. the same or different? you make the call!
what good is gold, or silver too, if your heart's not good and true -- hank williams, sr.
 
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pdhelp replied to susiemargaret's response:
Hi Susie Margeret

Thank you for the reply and the further clarification. I truly appreciate your efforts to help me out. From looking for definitions of Bradykinesia and Adiadochokinesia on the web, both seem to be treated as separate symptoms and not as a subset of one another.
Bradykinesia seems to refer to slowness of movement and is seen a neurological issue whereas
Adiodochokinesia seems to be more cerebral and refers to the "Lack of ability to stop movement in one direction and follow it immediately with movement in the opposite direction."

Thanks once again
 
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DUKE MEDICINE
Mark A Stacy, MD responded:
Hi, pdhelp
B12 deficiency is a treatable condition that causes a sensory loss. If this occurs the condition is also called: subacute combined degeneration of the spinal cord.

The loss of positions sensation causes a patient to not know where his feet are in space, and leads to gait difficulty. If you have a tremor... you may be called "PD."

DYSdiadochokinesia is a condition of poor coordination - and is from the sensory loss. Bradykinesia is slow movement and is from PD


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