Of dots and levels: a case of partial subacute combined degeneration

2020 ◽  
Vol 50 (4) ◽  
pp. 367-368
Author(s):  
Divyani Garg ◽  
Jerry A George ◽  
Rajinder K Dhamija
Keyword(s):  
Vitamin B12 Deficiency ◽  
Clinical Syndrome ◽  
Posterior Column ◽  
Sensory Level ◽  
Resonance Imaging ◽  
Subacute Combined Degeneration ◽  
Spinal Magnetic Resonance Imaging ◽  
Corticospinal Tracts ◽  
B12 Deficiency ◽  
Compressive Myelopathy

Subacute combined degeneration of the spinal cord is a typical clinical syndrome due to vitamin B12 deficiency, characterised by the involvement of the posterior column and corticospinal tracts. Occasionally, it may present with atypical features such as a sensory level and Lhermitte's sign, both traditionally considered to be a feature of compressive myelopathy. Spinal magnetic resonance imaging strongly augments the diagnosis by exhibiting changes in the posterior column in the form of a ‘dot’. We describe such a patient who responded to therapy.

scholarly journals The Level of Serum Pepsinogen in Diagnosing and Evaluating the Severity of Subacute Combined Degeneration Due to Vitamin B12 Deficiency

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoyan Chen ◽  
Rong Wang ◽  
Xusheng Huang ◽  
Fei Yang ◽  
Shengyuan Yu
Keyword(s):  
Vitamin B12 ◽  
Neurological Complication ◽  
Vitamin B12 Deficiency ◽  
Inverse Correlation ◽  
Cobalamin Deficiency ◽  
Serum Pepsinogen ◽  
Roc Curve Analysis ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency ◽  
Autoimmune Atrophic Gastritis

Subacute combined degeneration (SCD) is a neurological complication of cobalamin deficiency, which is usually caused by chronic autoimmune atrophic gastritis. Serum pepsinogen 1 and the ratio of pepsinogen 1/pepsinogen 2 (PG1/2) can reflect the severity of gastric atrophy.Objective: This work aims to investigate whether decreased serum PG1 and PG1/2 ratio are helpful in diagnosing SCD and reflecting the severity of SCD.Methods: We retrospectively analyzed the clinical and laboratory tests of 65 cases of SCD due to vitamin B12 deficiency and compared the laboratory parameters of SCD with 65 age- and sex-matched amyotrophic lateral sclerosis (ALS) patients.Results: PG1 and PG1/2 ratio were decreased in 80 and 52.3% of SCD patients, respectively. Compared to patients with PG1/2 ratio ≥3.0, patients with PG1/2 ratio <3.0 had more severe anemia, larger mean corpuscular volume (MCV), lower level of vitamin B12, higher folate and homocysteine (Hcy), more severe changes in somatosensory evoked potential (SEP), and higher rate of lesions in spinal MRI (P < 0.05). PG1 and PG1/2 ratio had inverse correlation with MCV and N20 latency in SEP examination (P < 0.05). PG1/2 ratio, RBC count, and Hcy were independent risk factors for SCD in logistic regression analyses. The ROC curve analysis revealed that the diagnostic accuracy of PG1 and PG1/2 ratio was 72.2 and 73.0%, respectively, while the cutoff values were 22.4 ng/ml and 2.43 for SCD, respectively.Conclusions: Decreased PG1 and PG1/2 ratio are helpful for the diagnosis and evaluation of the severity of SCD due to vitamin B12 deficiency.

Subacute Combined Degeneration of the Spinal Cord and Hydrocephalus Associated with Vitamin B12 Deficiency

2019 ◽  
Vol 128 ◽  
pp. 277-283 ◽  
Author(s):  
Wei Sun ◽  
Guangsheng Li ◽  
Zhaohui Lai ◽  
Zhijuan Lu ◽  
Ye Lin ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency

scholarly journals Helicobacter pylori associated vitamin B12 deficiency, pernicious anaemia and subacute combined degeneration of the spinal cord

2013 ◽  
Vol 2013 (sep29 1) ◽  
pp. bcr2013200380-bcr2013200380 ◽  
Author(s):  
H. B. Gowdappa ◽  
M. Mahesh ◽  
K. V. K. S. N. Murthy ◽  
M. G. Narahari
Keyword(s):  
Spinal Cord ◽  
Helicobacter Pylori ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Pernicious Anaemia ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency

scholarly journals Subacute Combined Degeneration of the Spinal Cord due to Different Etiologies and Improvement of MRI Findings

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Azize Esra Gürsoy ◽  
Mehmet Kolukısa ◽  
Gülsen Babacan-Yıldız ◽  
Arif Çelebi
Keyword(s):  
Spinal Cord ◽  
Nitrous Oxide ◽  
Vitamin B12 ◽  
Neurological Complication ◽  
Vitamin B12 Deficiency ◽  
Vegetarian Diet ◽  
Mri Findings ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency ◽  
Reversible Condition

Subacute combined degeneration (SCD) is a rare neurological complication of vitamin B12 deficiency, characterized by demyelination of the dorsal and lateral spinal cord. Herein, we describe three cases, who presented with SCD, one related to reduced intake of vitamin B12 because of a vegetarian diet and two related to nitrous oxide exposure during surgery. MR images of our patients revealed symmetrical hyperintense signals in dorsal and lateral columns in T2 weighted series. After treatment with intramuscular B12 injections (1 mg daily for 2 weeks, once weekly thereafter for three months) all patients showed improvement of their symptoms. Abnormalities of the spinal cord on MRI resolved in three months. In conclusion, SCD either due to nitrous oxide exposure or due to reduced intake of vitamin B12 is a reversible condition, when detected and treated early.

Magnetic Resonance Imaging of the Posterior Columns in Vitamin B12 Deficiency

2004 ◽  
Vol 61 (8) ◽  
Author(s):  
Michael S. Okun ◽  
Kraiyuth Vongxaiburana ◽  
Edward Valenstein ◽  
William Friedman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Resonance Imaging ◽  
B12 Deficiency

A New Loss of Order

2016 ◽  
Author(s):  
Richard A. Walsh
Keyword(s):  
Genetic Testing ◽  
Genetic Disorders ◽  
Vitamin B12 Deficiency ◽  
Cerebellar Degeneration ◽  
Paraneoplastic Syndromes ◽  
Adult Onset ◽  
Resonance Imaging ◽  
B12 Deficiency ◽  
Reduce Risk ◽  
Generation Sequencing

The priority in the investigation of sporadic adult-onset ataxia is to identify potentially treatable causes, to improve gait or to reduce risk of recurrence. Disorders such as multiple sclerosis, alcohol-related cerebellar degeneration, and vitamin B12 deficiency are far more common than rarer causes such as paraneoplastic syndromes or recessive genetic disorders. Routine biochemistry, magnetic resonance imaging, and cerebrospinal fluid studies are typically performed as part of the workup to guide any further intervention and investigations. Advances in genetic testing using next-generation sequencing are revealing that many patients with presumed nongenetic sporadic ataxias have a genetic cause for their symptoms. Expert opinion to guide genetic testing in cases in which no alternative cause of ataxia is found is advisable.

Oral treatment of vitamin B12 deficiency proven effective in subacute combined degeneration

2005 ◽  
Vol 32 (S 4) ◽  
Author(s):  
J Wellmer ◽  
J Hoever ◽  
K.U Sturm ◽  
R Obeid ◽  
W Herrmann ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Oral Treatment ◽  
Vitamin B12 Deficiency ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency
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