Summary: Balance disorders and dizziness are some of the most common symptoms encountered in neurological practice. Severe gait disturbances and ataxia (as a consequence of vertigo and dizziness) may result from dysfunction of the central or peripheral part of the nervous system, or both. The feeling of anxiety and fear of falling often require the physician to pay extra attention when describing the emotional state of the patient, which also prompts differential psychiatric diagnosis, especially in the aspect of panic disorder. Damage to the posterior cords of the spinal cord is one of the many causes of ataxia. The posterior cord syndrome with ataxia may be caused by a local pathological process or by generalized and deficient metabolic disorders.
In the diagnosis of ataxia, especially in patients with features of the posterior cord syndrome, the etiology of cyanocobalamin deficiency and the absence or deficiency of Castle factor should be taken into account. Symptoms related to vitamin B12 deficiency are manifested mainly by hematological disorders and symptoms of neurological deficit associated with cord degeneration. The following article discusses the most common neuropsychiatric symptoms of encephalopathy and deficient myelopathies.