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Required Medical Stability: Patients must not have decompensated neurological conditions (e.g., advanced multiple sclerosis or Parkinsons disease), as these may affect the therapys ability to restore normal sleep patterns

It typically presents as macrocytic megaloblastic anemia and neurological impairments, including sensory and motor disfunctions, predominantly in the lower extremities, ataxia, and in more advanced stages cognitive decline progressing to dementia, as well as psychiatric disturbances (Sanjay et al., 2022