Causes/Etiology

Pernicious anemia

Chronic Pancreatitis

H. pylori

SIBO - Small Intestine Bacteria Overgrowth

Crohn’s Disease

Ilectomy > 60 cm

Subacute combined degeneration

Presentation

• Megaloblastic Anemia (Macrocytic Anemia (> 100))
• Sensory Ataxia
• RLS - Restless Legs Syndrome
• Optic neuritis (uncommon, but happens)
• LMN signs + UMN signs
  • Peripheral nerves, DC/ML, pyramidal tracts
  • can have hyperreflexia and spasticity (UMN signs)