MRI in the diagnostic and evolutive control of subacute combined degeneration. A case report

Authors

  • R. Saiz-Mendiguren Clínica Universidad de Navarra
  • R. García-Eulate Clínica Universidad de Navarra
  • A. García-Lallana Clínica Universidad de Navarra
  • P. Irimia-Sieira Clínica Universidad de Navarra
  • E.A. Martínez-Vila

Keywords:

Degeneración combinada subaguda, médula espinal, resonancia magnética, déficit vitamina B12

Abstract

A deficit of vitamin B12, generally resulting from pernicious anaemia, can give rise to disorders of the spinal cord, brain, optic and peripheral nerves. The principal neurological syndrome is subacute combined degeneration of the spinal cord (SCD), which can cause progressive motor and/or sensitive alterations, instability and incontinency, due to the demyelination of the posterior horn of the spinal cord. The identification by magnetic resonance (MR) of signal hyperintensity in T2 weighted sequences at the level of the posterior horns of the spinal and/or cervical cord can be of great use in diagnosising the patient with SCD, above all when the symptoms are mild or nonspecific, and the patient does not have haematological or gastrointestinal alterations. Besides, the evolution of the altered signal of the posterior horns in MR can be of use in evaluating the efficacy of treatment, since their normalization is related to clinical improvement.

Downloads

Download data is not yet available.

References

1. SCALABRINO G. Cobalamin (vitamin B12) in subacute combined degeneration and beyond: traditional interpretations and novel theories. Exp Neurol 2005; 192: 463-479.

https://doi.org/10.1016/j.expneurol.2004.12.020

2. KARANTANAS AH, MARKONIS A, BISBIYIANNIS G. Subacute combined degeneration of the spinal cord with involvement of the anterior columns: a new MRI finding. Neuroradiology 2000; 42: 115-117.

https://doi.org/10.1007/s002340050027

3. RABHI S, MAAROUFI M, KHIBRI H, BELAHSEN F, TIZNITI F, BERRADY R ET AL. Magnetic resonance imaging findings within the posterior and lateral columns of the spinal cord extended from the medulla oblongata to the thoracic spine in a woman with subacute combined degeneration without hematologic disorders: a case report and review of the literature. J Med Case Reports 2011; 5: 166-169.

https://doi.org/10.1186/1752-1947-5-166

4. TIMMS SR, CURE JK, KURENT JE. Subacute combined degeneration of the spinal cord: MR findings. AJNR Am J Neuroradiol 1993; 14: 1224-1227.

5. YAMADA K, SHRIER DA, TANAKA H, NUMAGUCHI Y. A case of subacute combined degeneration: MRI findings. Neuroradiology 1998; 40: 398-400.

https://doi.org/10.1007/s002340050610

6. BASSI SS, BULUNDWE KK, GREEFF GP, LABUSCAGNE JH, GLEDHILL RF. MRI of the spinal cord in myelopathy complicating vitamin B12 deficiency: two additional cases and a review of the literature. Neuroradiology 1999; 41: 271-274.

https://doi.org/10.1007/s002340050746

7. BOU-HAIDAR P, PEDUTO AJ, KARUNARATNE N. Differential diagnosis of T2 hyperintense spinal cord lesions: Part B. J Med Imaging Radiat Oncol 2009; 53: 152-159 .

https://doi.org/10.1111/j.1754-9485.2009.02067.x

8. MAAMAR M, MEZALEK ZT, HARMOUCHE H, ADNAOUI, AOUNI M, MAAOUNI A. Contribution of spinal MRI for unsuspected cobalamin deficiency in isolated sub-acute combined degeneration. Eur J Intern Med 2008; 19: 143-145.

https://doi.org/10.1016/j.ejim.2007.03.017

9. MISRA UK, KALITA J. Comparison of clinical and electrodiagnostic features in B12 deficiency neurological syndromes with and without antiparietal cell antibodies. Postgrad Med J 2007; 83: 124-127.

https://doi.org/10.1136/pgmj.2006.048132

10. BERLIT P, RINGELSTEIN A, LIEBIG T. Spinal MRI precedes clinical improvement in subacute combined degeneration with B12 deficiency. Neurology 2004; 63: 592.

https://doi.org/10.1212/01.WNL.0000133406.50055.41

Published

2012-09-05

How to Cite

1.
Saiz-Mendiguren R, García-Eulate R, García-Lallana A, Irimia-Sieira P, Martínez-Vila E. MRI in the diagnostic and evolutive control of subacute combined degeneration. A case report. An Sist Sanit Navar [Internet]. 2012 Sep. 5 [cited 2026 Jan. 21];35(2):329-33. Available from: https://recyt.fecyt.es/index.php/ASSN/article/view/15755

Issue

Section

Clinical notes

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.