Of dots and levels: a case of partial subacute combined degeneration. (October 2020)

• Record Type: Journal Article
• Authors: Garg, Divyani; George, Jerry A; Dhamija, Rajinder K
• Is Part Of: Tropical doctor. Volume 50:Number 4(2020)
• Page Start: 367
• Page End: 368
• Publication Date: 2020-10
• Subjects: Subacute combined degeneration -- vitamin B12 -- sensory level -- Lhermitte's sign; Tropical medicine -- Periodicals; Medical care -- Developing countries -- Periodicals; Developing Countries -- Periodicals; Tropical Medicine -- Periodicals; Tropische geneeskunde; 616.9883
• DOI: 10.1177/0049475520932201
• Languages: English
• ISSNs: 0049-4755

Abstract

Subacute combined degeneration of the spinal cord is a typical clinical syndrome due to vitamin B12 deficiency, characterised by the involvement of the posterior column and corticospinal tracts. Occasionally, it may present with atypical features such as a sensory level and Lhermitte's sign, both traditionally considered to be a feature of compressive myelopathy. Spinal magnetic resonance imaging strongly augments the diagnosis by exhibiting changes in the posterior column in the form of a 'dot'. We describe such a patient who responded to therapy.