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Subacute combined degeneration is the term used for the myelopathy associated
with Vitamin B12 deficiency (often caused by failure to absorb this vitamin from
the gut owing to lack of intrinsic factor in patients with pernicious anemia).
Although there is often a superimposed peripheral neuropathy, several tracts
of the spinal cord are affected, most prominently the posterior columns and less
so the corticospinal tracts. The most common presentation is gait disturbance
and/or lower extremity paresthesias and numbness. Vitamin B12
deficiency may also affect cognitive function and is considered one of the
reversible or treatable dementia syndromes. In some cases of subacute combined
degeneration, changes on MRI may be present. |
