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[6] [7] Common neurological presentations include: Peripheral neuropathy – tingling, numbness, or pins-and-needles sensations (paraesthesia), typically beginning in the feet and hands in a symmetrical 'glove and stocking' distribution Gait disturbances – unsteadiness, difficulty walking, or loss of balance due to proprioceptive impairment Cognitive changes – memory problems, confusion, difficulty concentrating, or 'brain fog' Mood alterations – depression, irritability, or personality changes Weakness – muscle weakness or fatigue affecting daily activities Visual disturbances – rarely, optic neuropathy causing blurred or reduced vision In more severe cases, patients may develop subacute combined degeneration of the spinal cord , a serious condition affecting the posterior and lateral columns