stylistic:tone, linguistic:voice_change
Neurological decline

Severe vitamin B deficiency is associated with subacute combined degeneration of the spinal cord, which involves demyelination of the posterior and lateral columns of the spinal cord. Symptoms include memory and cognitive impairment, sensory loss, motor disturbances, personality changes, disorientation, irritability, dementia, loss of posterior column functions and disturbances in proprioception. In advanced stages of vitamin B deficiency, cases of psychosis, paranoia and severe depression have been observed, which may lead to permanent disability if left untreated. Studies have shown the rapid reversal of the neurological symptoms of vitamin B deficiency, after treatment with high-dose of vitamin B supplementation; suggesting the importance of prompt treatment in reversing neurological manifestations.