Progressive subacute combined degeneration: a severe relapse with discontinuation of vitamin B12 treatment

Abstract

Subacute combined degeneration (SCD) is a rare neurological complication of vitamin B12 deficiency, characterized by the demyelination of dorsal and lateral spinal cord. Clinical manifestations of SCD are symmetric dysesthesia, disturbance of position sense and spastic paraparesis or tetraparesis. Vitamin B12 deficiency causes a wide range of hematological, gastrointestinal, psychiatric and neurological disorders. The most consistent magnetic resonance imaging (MRI) finding is a symmetrical abnormally increased T 2 signal intensity confined to posterior or posterior and lateral columns in the spinal cord. We report a case with progressive SCD due to vitamin B12 deficiency. We aimed to discuss the clinical and radiological features of SCD in the literature review and emphasize the importance of early diagnosis and treatment.