Description: A 55-year-old man with megaloblastic anemia, progressive weakness of lower limbs, gait disturbance, and ataxia 55岁男性,巨幼红细胞性贫血患者。渐进性双下肢无力、步态不稳、共济失调。 图A: 图B: Legends: Sagittal STIR (A) and axial T2WI (B) demonstrate symmetric increased signal (arrows) along the dorsal columns of the spinal cord. 矢状位STIR (A)及横断位T2WI (B) 示脊髓后索对称性高信号。 图A: 图B: Subacute Combined Degeneration 脊髓亚急性联合变性 Subacute combined degeneration is an acquired myelopathy caused by vitamin B12 deficiency, and is a rare cause of demyelination of the dorsal columns of the spinal cord. 亚急性联合变性是由于维生素B12缺乏所致的脊髓病变,是脊髓后索脱髓鞘病变的罕见诱因之一。 Clinical Presentation: Profound neurologic deficits, including progressive sensory abnormalities, ascending paresthesias, weakness, ataxia, loss of sphincter control, and gait impairment. Megaloblastic anemia is a common early symptom leading to the diagnosis; although, neurologic symptoms may occur in the absence of haematologic abnormalities. 严重的神经功能缺陷,包括渐进性的感觉异常、不断加重的皮肤感觉障碍、虚弱、共济失调、大小便失禁(括约肌功能丧失)和步态障碍。巨幼细胞性贫血是常见的早期症状,也有部分患者不伴有血液系统异常。 Key Diagnostic Features:
DDx:
Rx: Vitamin B12 therapy 维生素B12治疗 |
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来自: 昵称42715024 > 《头及颈部》