Mirroring spinal cord lesion secondary to B12 deficiency
Youssouf Benmoh, Ahmed Bourazza
The Pan African Medical Journal. 2017;26:130. doi:10.11604/pamj.2017.26.130.11853

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Mirroring spinal cord lesion secondary to B12 deficiency

Cite this: The Pan African Medical Journal. 2017;26:130. doi:10.11604/pamj.2017.26.130.11853

Received: 04/02/2017 - Accepted: 07/03/2017 - Published: 07/03/2017

Key words: B12 deficiency, combined sclerosis, spinal cord, MRI

© Youssouf Benmoh et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/26/130/full

Corresponding author: Youssouf Benmoh. Department of Neurology, Military Hospital MOHAMED V, Rabat, Morocco (youssouf1680@gmail.com)


Mirroring spinal cord lesion secondary to B12 deficiency

Youssouf Benmoh1, Ahmed Bourazza1

 

1Department of Neurology, Military Hospital MOHAMED V, Rabat, Morocco

 

 

&Corresponding author
Youssouf Benmoh. Department of Neurology, Military Hospital MOHAMED V, Rabat, Morocco

 

 

Image in medicine    Down

A 26 year-old girl, previously healthy, admitted for progressive weakness of both lower limbs, with permanent paresthaesia evolving for 6 months. Clinical examination found spastic paraparesis with proprioceptive ataxia. The MRI showed bilateral and symmetrical lesions in the cervical spinal cord. Lesions were T1-isointense and T2 hyperintense, located on both lateral and posterior funiculus without enhancement. Investigation revealed deep vitamin B12 deficiency (27pg/ml), macrocytosis, with positive parietal cell-antibody and fundic gastritis. Patient was treated with intra muscular hydorxycobalamin. Evolution was favorable with regression of weakness and parethaesia of both lower limbs, and persistence of discreet ataxia. Cobalamin deficiency is common in the elderly. It causes hematologic, digestive and neurological disorders. Neurological signs are dominated by combined sclerosis of the spinal cord, and peripheral neuropathy. MRI is useful in front of myelopathy, showing an enlargement or T2-hyperintense lesion of the posterior funiculus.

 

 

Figure 1: ( A,B) MRI of the spinal cord, in sagittal T2 weighted image showing an increased signal intensity extended to the whole cervical spinal cord; (C ,D) MRI of the spinal cord, in axial T2 weighted image, showing increased bilateral and symmetrical signal intensity of lateral and posterior funiculus.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved