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Case No. 186
0000-00-00~0000-00-00
출제자 : 관리자
Hit : 354
| Period | 0000-00-00~0000-00-00 |
|---|---|
| Diagnosis | |
| Clinical information | 66세 남자, 3주전부터 시작된 양측 손 근력과 감각 저하로 내원. |
| Discussion | Subacute combined degeneration Review: Subacute combined degeneration is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and even more rarely of the pyramidal and spinocerebellar tracts and cerebellum. Vitamin B12 deficiency can induce subacute combined degeneration (SCD) of the spinal cord. There is degeneration of myelin and axons and, at a later stage, axonal loss and Wallerian degeneration of the posterior and lateral columns of the spinal cord, typically beginning in the thoracic region and ascending or descending. The neurological disturbances consist of dysaesthesiae and disturbance of deep sensation, mainly affecting the legs and typically manifest as sensory ataxia. MRI studies of the cervical spinal cord shows the demyelination of the dorsal columns as high intensity lesions on T2-weighted images. MRI also demonstrates contiguous involvement of multiple segments of the cord. The cord abnormality can resolve without evidence of cord atrophy, if treated early. Reverences 1. Katsaros VK, Glocker FX, Hemmer B, Schumacher M. MRI of spinal cord and brain lesions in subacute combined degeneration. Neuroradiology 1998 Nov;40(11):716-9. 2. Srikanth SG, Jayakumar PN, Vasudev MR, Taly AB, Chandrashekar HS. MRI in subacute combined degeneration of spinal cord: a case report and review of literature. Neurol India 2002 Sep;50(3):310-2. |
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