Background: Ataxia due to a vitamin B12 deficiency can be a cause of falls in elderly patients.
Case description: An 86-year-old woman presented with functional decline and gait problems. She had been falling regularly. The patient's gait was ataxic and she was unable to stand without support. Additional laboratory tests showed a volume macrocytic blood picture and a severe vitamin B12 deficiency, as well as antibodies directed against intrinsic factor and parietal cells. We diagnosed her as having falls and ataxia caused by vitamin B12 deficiency. Vitamin B12 supplementation resulted in improvement of gait.
Conclusion: Ataxia due to vitamin B12 deficiency is a rare problem which in 20-25% of cases is not accompanied by anaemia. Prompt treatment reduces the chance of neurological sequelae.