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J Neurocrit Care 2013;6(1): 36-39.
A Case of Reversible Myelopathy Associated with Severe Atrophic Gastritis
Young Chul Choi, MD, Dong Joo Yun, MD, Youngchai Ko, MD, Sang Hyun Jang, MD, Soo Jin Yoon, MD, Gun-Sei Oh, MD and Soo Joo Lee, MD
Department of Neurology, Eulji University School of Medicine, Daejeon, Korea
Background: Subacute combined degeneration (SCD) of the spinal cord is a neurologic complication of vitamin B12 deficiency. Few cases of follow up electrophysiological studies and MRI improvement on therapy have been recorded.
Case Report: We report a 74-year-old man with vitamin B12 deficiency who presented with severe neurologic deficits associated with long T2-weighted hyperintensities on spine MRI, accompanied by sensorimotor polyneuropathy. Two months after vitamin B12 therapy, there was clinical improvement and striking reduction in the MRI abnormalities, but nerve conduction studies and somatosensory evoked potentials had not changed.
Conclusions: SCD is curable and MRI may be a useful addition to the clinical assessment in monitoring the efficacy of treatment. However, the coexistence with peripheral neuropathy could determine the incomplete clinical recovery.
Key Words: Subacute combined degeneration · Vitamin B12 deficiency · Polyneuropathy
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