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Description
Myokymia of the lower face and tongue, increased by voluntary activation, is a characteristic feature of Kennedy disease or X-linked spinal and bulbar muscular atrophy (63)

Gently swirl the vial in a circular motion to dissolve the powder

Patients should also report recreational nitrous oxide use, as this can inactivate vitamin B12 and cause neurological symptoms

What Are the First Signs That a B12 Shot Is Working

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