Subacute combined degeneration of the spinal cord due to vitamin B12 deficiency

• Published in: BMJ case reports Vol. 2011; no. aug04 1; p. bcr0320114030
• Main Authors: Fenton, Jon, Rajakulendran, Sanjeev, Chinn, Roger, Janssen, John C
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 04.08.2011; BMJ Publishing Group
• Series: Images in
• Subjects: 80 years; Aged, 80 and over; Europe (West); Female; Handwriting; Humans; Images In; Spinal cord; Subacute Combined Degeneration - etiology; Vitamin B 12 Deficiency - complications; White
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr.03.2011.4030

Later, examination is consistent with a disorder of the dorsal and lateral columns of the spinal cord with loss of vibration sense and impaired proprioception being the most reliable signs. Interestingly, there may not be a macrocytic anaemia and it is thought that the degree of anaemia may correlate inversely with any neurological signs and symptoms. 2 A normal vitamin B12 level should raise the possibility of copper deficiency. 3 Early replenishment of vitamin B12 body stores is associated with a better prognosis and reduces the likelihood of long-term residual disability. 2 Many neurologists would treat immediately after taking a blood sample, that is, before the results became available, if the clinical diagnosis was suspected.