Subacute combined degeneration of spinal cord
Subacute combined degeneration of spinal cord, also known as Lichtheim's disease,[1][2] refers to degeneration of the posterior and lateral columns of the spinal cord as a result of vitamin B12 deficiency (most common), vitamin E deficiency or Friedrich's ataxia. It is usually associated with pernicious anemia.
Presentation
The pathological findings of subacute combined degeneration consist of patchy losses of myelin in the dorsal and lateral columns. Patients present with weakness of legs, arms, trunk, tingling and numbness that progressively worsens. Vision changes and change of mental state may also be present. Bilateral spastic paresis may develop and pressure, vibration and touch sense are diminished. A positive Babinski sign may be seen. Prolonged deficiency of vitamin B12 leads to irreversible nervous system damage.
If someone is deficient in vitamin B12 and folic acid, the vitamin B12 deficiency must be treated first to avoid precipitating subacute combined degeneration of the cord.
Treatment
Therapy with vitamin B12 results in partial to full recovery, depending on the duration and extent of neurodegeneration.
References
- ^ synd/492 at Who Named It?
- ^ L. Lichtheim. Zur Kenntnis der perniciösen Anämie. Verhandlungen des Deutschen Kongress für innere Medizin, 1889, 6: 84-96. 42: 1887.
External links
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autoimmune ( Multiple sclerosis, Neuromyelitis optica, Schilder's disease) · hereditary ( Adrenoleukodystrophy, Alexander, Canavan, Krabbe, ML, PMD, VWM, MFC, CAMFAK syndrome) · Central pontine myelinolysis · Marchiafava-Bignami disease · Alpers' disease
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Spinal cord/
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noco(m/d/e/h/v/s)/cong/tumr, sysi/epon, injr
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