Acute demyelination with leukoencephalopathy and cerebellar involvement in vitamin B12 deficiency

Abstract

A 49-year-old woman presented with progressive ascending quadriparesis associated with paresthesias and recent wide-based gait. Cognitive impairment associated with reduced vibration and proprioception sense was observed. Brain MRI documented the presence of extensive white matter demyelination (Figure 1). Megaloblastic anemia, low B12 level and chronic gastritis were confirmed (Figure 2

A case of subacute combined spinal cord degeneration and suspected leukoencephalopathy associated with vitamin B₁₂ deficiency showing improved imaging findings after vitamin B₁₂ administration

“…MRI findings of leukoencephalopathy associated with vitamin B12 deficiency reportedly includes multiple focal or confluent T2WI / FLAIR-high signal intensities in the periventricular white matter, with some reports showing abnormal signals in the cerebellum (2,10,11). There are few reports describing DWI, with some reports indicating that it was completely or partially reversible (12,13), whereas others showed a high signal but no description of responsiveness to treatment (14). Moreover, we could not find any reports describing ADC map.…”