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Contribution of spinal MRI for unsuspected cobalamin deficiency in isolated sub-acute combined degeneration.

Maamar M, Mezalek ZT, Harmouche H, Adnaoui M, Aouni M, Maaouni A

Department of Internal Medicine, Ibn Sina hospital, Rabat, Morocco.

Sub-acute combined degeneration (SCD) is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and is a neurological complication due to vitamin B12 deficiency. Revealing forms of SCD without anemia are rare. We report a case of SCD of the spinal cord in a 33-year-old woman without anemia but with a 10-month history of paresthesis and urine imperiosity. Magnetic resonance imaging (MRI) of the spine showed intramedullary hyperintensity seen on T2-weighted images in the posterior column of the cervico-dorsal spinal cord, extending from C1 to D1. A diagnosis of SCD of the spinal cord was considered and confirmed by a low serum cobalamin. The patient was treated with vitamin B12 supplements and showed gradual improvement in her clinical symptoms.

Published 5 February 2008 in Eur J Intern Med, 19(2): 143-5.
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