We report two patients with subjectively progressive sensory symptoms and gait disturbance due to cobalamin deficiency, but only slight or absent abnormalities on neurological examination. In both patients, spinal MRI provided evidence for a myelopathic origin of the symptoms, disclosing characteristic T2 hyperintense signal alterations confined to the posterior columns of the cervical and thoracic spinal cord. The patients illustrate the early clinical presentation of subacute combined degeneration (SCD) with a sensory neuropathy starting with acroparesthesia and Lhermitte’s sign. Furthermore, the diagnostic value of spinal MRI for early diagnosis of SCD with characteristic findings is highlighted.
© 2003 S. Karger AG, Basel
Department of Neurology
University of Bern
CH–3010 Bern (Switzerland)
Tel. +41 31 632 33 81, Fax +41 31 632 48 37, E-Mail email@example.com
Received: September 27, 2002
Accepted: November 19, 2002
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 0, Number of References : 20
Founded 1897 as ‘Monatsschrift für Psychiatrie und Neurologie’
Vol. 49, No. 3, Year 2003 (Cover Date: Released March 2003)
Journal Editor: J. Bogousslavsky, Lausanne
ISSN: 0014–3022 (print), 1421–9913 (Online)
For additional information: http://www.karger.com/journals/ene
Article / Publication Details
Published online: 3/28/2003
Issue release date: March 2003
Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 0
ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)
For additional information: http://www.karger.com/ENE
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