Reversible subacute chorea caused by nutritional deficiency
Bibliographic record
Abstract
We present a case of a 70-year-old lady with a six weeks history of progressive encephalopathy with visual hallucinations and choreiform movements of the right upper and lower limbs. Her past medical history included a longstanding eating disorder, Vitamin B12 deficiency, and several falls resulting in fractures. On examination, there was a right sided hemichorea with orofacial dyskinesia. Her speech was tangential and confabulatory. The remainder of the examination was normal. She scored 18/30 on Montreal Cognitive Assessment (MOCA). Investigations demonstrated a macrocytic anaemia with a low serum folate. Vitamin B12 was at the lower end of normal (287 pg/ml) with a raised homocysteine (indicating functional deficiency). MRI brain and cord was normal. CSF examination was unremarkable with the exception of CSF specific oligoclonal bands (not present on repeat testing). Extended autoantibody screening was negative with a negative CT CAP. She was treated with pabrinex, B12 injections, and folate replacement with complete resolution of her symptoms. On six month follow up, her cognitive improved with a score of 27/30 on MOCA. Although rare, B12 deficiency is a treatable cause of chorea that should not be missed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".