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Case No. 528
2019-09-01~2019-09-30
출제자 : 박미나
Hit : 302
| Period | 2019-09-01~2019-09-30 |
|---|---|
| Diagnosis | Subacute combined degeneration |
| Gender |
|
| Age | 21 |
| Clinical information | 21세 여환 Hx> 내원 3일전 발생한 Progressive leg weakness, both limb hypoesthesia, bladder dysfunction 을 주소로 내원하였음. 해피 벌룬을 흡입한 과거력 있음. 진단은? |
| Discussion | Subacute combined degeneration = Vitamin B12 deficiency : produce selective degeneration of dorsal and/or lateral spinal cord column Cause - m/c malabsorption - N2O gas inhalation - : N2O inactivates B12 accumulation of methylmalonic acid myelin toxicity - : irreversible oxidization of active reduced B12 form to inactive form Imaging - Longitudinal dorsal cord T2 signal abnormality - Inverted V or inverted rabbit ears on axial images (within dorsal spinal cord) - Possible mild dorsal column enhancement |
| Correct answer |
Correct Answer
Semi-Correct Answer |