MR appearances in vitamin B12 neuropathy. Open in a separate window. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. Spinal MRI supporting myelopathic origin of early symptoms in unsuspected cobalamin deficiency. Reversible myelopathy in a year-old man degneeracion vitamin B12 deficiency.

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ABSTRACT The megaloblastic anemia in mild climates is the main cause of the deficiency of cobalamine, is a disease of the elderly, affects males and females equally, and appears in average at 60 years of age. In the megaloblastic anemia is autoimmunity against gastric parietal cells, therefore there is an absence of intrinsic factor.

The spinal cord, brain, and optic and peripheral nerves can be affected because of B12 vitamin cobalamine deficiency. The spinal cord is usually the first to be affected and often the only one. It is used the term subacute combined system disease regarding to a lesion of the spinal cord secondary to B12 vitamin deficiency.

The earliest histological change is the nerve demyelination. The clinical manifestations includes generalized weakness and paresthesias in feet and hands, besides irritability, apathy, somnolence and emotional instability, even depressive or confusional psychosis. The physical exam exhibits posterior and lateral column involvement of the spinal cord. The diagnosis is based on the measurement of seric B12 nivel. The treatment must begin as soon as the diagnosis is made.

Key words: Spinal cord, B12 vitamin, subacute combined system disease, megaloblastic anemia. Posteriormente la marcha se vuelve inestable y vacilante, con debilidad de las extremidades, especialmente de las inferiores. Tratamiento Al diagnosticar una deficiencia combinada subaguda medular es necesario administrar inmediatamente vitamina B12 y continuar el tratamiento de 90 por vida.

El sistema sensitivo superficial, tacto, dolor y temperatura se encontraron normales. Hubo bloqueo total de los potenciales somatosensitivos en las cuatro extremidades. Figura 1. Proeritroblasto megaloblasto. Figura 3. Harrison, Principios de medicina interna. Vol II. Interamericana McGraw-Hill, 12a ed, ; Principles of neurology.

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Degeneración combinada subaguda de la médula



Degeneración combinada subaguda de médula


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