Wheelchair-bound woman walks again after Mumbai docs discover rare deficiency 

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A 38-year-old woman from Mozambique, who had been undergoing treatment for psychiatric symptoms, anxiety, and persistent stomach discomfort—all of which were attributed to a psychological condition gradually lost the ability to walk. She has now made a remarkable recovery after doctors in Mumbai came to her rescue to not only discover the hidden reason but also treat her.

Dr Prashant Makhija, who is the consultant neurologist at Wockhardt Hospitals in Mumbai Central, identified a rare neurological disorder caused by severe Vitamin B12 deficiency resulting from autoimmune atrophic gastritis.

The young woman had initially developed persistent stomach discomfort along with anxiety and other psychiatric symptoms. As her condition progressed, she began experiencing increasing difficulty in walking. Over time, the weakness worsened to the point that she became completely wheelchair-bound and required assistance even for routine daily activities. Since her symptoms were believed to be psychological in origin, she continued receiving psychiatric treatment. However, her condition kept deteriorating, prompting her family to seek specialised neurological care in Mumbai.

When she arrived at the hospital, Dr Makhija conducted a detailed neurological evaluation. On examination, she had sensory-motor paraparesis, marked stiffness in both legs, and significantly reduced sensation below the knees, suggesting involvement of the spinal cord rather than a primary psychiatric disorder.

“The combination of progressive weakness, stiffness in both legs, and impaired sensation suggested that something was affecting the spinal cord. At the same time, her history of persistent stomach discomfort stood out as an important clue. Rather than looking at these symptoms in isolation, it was important to connect them and search for a common underlying cause,” said Dr Makhija.

Considering her gastrointestinal symptoms, Dr. Makhija coordinated further evaluation with the gastroenterology team. An upper gastrointestinal endoscopy revealed atrophic gastritis, an autoimmune condition in which the stomach lining is damaged, reducing the production of intrinsic factor—a protein essential for the absorption of Vitamin B12.

Further investigations confirmed that the patient had pernicious anaemia, a rare autoimmune disorder that prevents adequate Vitamin B12 absorption. The prolonged deficiency had led to Subacute Combined Degeneration (SCD) of the spinal cord, a rare but potentially reversible neurological condition that damages the nerve pathways responsible for movement and sensation.

An MRI of the spine showed characteristic involvement of the posterior and lateral columns of the spinal cord, confirming the diagnosis and explaining the progressive weakness, stiffness, and sensory loss.

“Vitamin B12 deficiency is commonly associated with anaemia, but in severe cases it can also damage the spinal cord. In this patient, the deficiency had progressed to Subacute Combined Degeneration, which is uncommon but highly important to recognise because, unlike many other spinal cord disorders, it can be reversed if diagnosed and treated early,” Dr. Makhija explained.

Once the diagnosis was established, treatment was initiated with intensive Vitamin B12 replacement therapy.

“The treatment itself was relatively straightforward once we identified the underlying cause. What was truly remarkable was her response. Within a week, a patient who had been unable to move her legs independently, even while lying in bed, began taking assisted steps. Such recoveries reinforce the importance of recognising treatable neurological conditions before permanent damage occurs,” Dr. Makhija added.

Although the woman continues to undergo rehabilitation, her neurological recovery has been encouraging. She has already regained partial mobility, and her treating team expects continued improvement over the coming weeks, with the goal of helping her regain functional independence over the next two to three months.

Vitamin B12 deficiency is often overlooked because its early symptoms may include fatigue, tingling sensations, numbness, memory changes, mood disturbances, difficulty maintaining balance, or psychiatric symptoms. When left untreated, prolonged deficiency can affect the brain, spinal cord, and peripheral nerves, resulting in irreversible neurological damage. Pernicious anaemia remains an uncommon but important cause of severe Vitamin B12 deficiency and can easily be mistaken for other neurological or psychiatric disorders if not recognised in time.

“This case highlights why a detailed clinical examination remains the cornerstone of neurological diagnosis. Not every patient presenting with weakness or behavioural symptoms has a primary neurological or psychiatric disorder. Sometimes, these symptoms may actually be the result of an underlying medical condition elsewhere in the body. Identifying the root cause at the right time can completely change the patient’s outcome, as it did in this case,” said Dr. Makhija.

At a time when there are so many possibilities, this case also highlights how careful clinical evaluation, attention to seemingly unrelated symptoms, and timely diagnosis of a rare but treatable condition helped transform the life of a young woman who had lost the ability to walk, allowing her to take her first assisted steps again within days of receiving the correct treatment.