Intended for healthcare professionals

Rapid response to:

Clinical Review

Guillain-Barré syndrome

BMJ 2008; 337 doi: (Published 17 July 2008) Cite this as: BMJ 2008;337:a671

Rapid Response:

Vitamin B.12 and demyelination

The neuro-pathology of "Demyelination" of Guillane-Barre syndrome is
shared with Neuromyelitis Optica, Multiple Sclerosis, Motor Neurone
Disease, Idiopathic Paroxysmal Vertigo and Herpes Zoster, together with
other entitled syndromes.

Vitamin B.12 (cyanocobalamin and hydroxocobalamin) has a known
effectiveness in Herpes Zoster when given early. This has been known since
1944. It is certainly ineffective after three months and perhaps less.

However, in many of these syndromes, by the time the ultimate dread
diagnosis is made since it takes time before a Consultant's opinion is
eventually obtained, it is very possible that Vitamin B.12 would then be
quite ineffective.

Cyanocobalamin is essential for the formation of Myelin: OVESEN, L.
"DRUGS" 27 148 (1984). Martindale's Pharmacopoeia.

A series of cases has been reviewed and there is evident instant
relief from pain when Vitamin B.12 is given early to cases of Zoster and
there is no Post Herpetic Neuralgia.

In the suspected cases of these other demyelination syndromes, why
not then adminster early intramuscular injections of B.12? Perhaps they
have been tried, but perhaps too late to have any beneficial effect?

Competing interests:
None declared

Competing interests: No competing interests

02 August 2008
George Y Caldwell
general practitioner
Singapore 259858
31 Balmoral Park, #18-33,