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  • Title: [Combined sclerosis of the spinal cord revealing vitamin B 12 deficiency: geriatric characteristics apropos of a case evaluated by MRI].
    Author: Beauchet O, Exbrayat V, Navez G, Blanchon MA, Quang BL, Gonthier R.
    Journal: Rev Med Interne; 2002 Mar; 23(3):322-7. PubMed ID: 11928381.
    Abstract:
    INTRODUCTION: Cobalamin deficiency is common in the elderly. However, most of the patients are asymptomatic or present with few symptoms. A subacute combined degeneration of the spinal cord accounts for only 10% of the neurological complications. Revealing forms of this myelopathy are exceptional, and were rarely documented by magnetic resonance imaging (MRI) study. EXEGESIS: We report a case of subacute combined degeneration of spinal cord in an 81-year-old woman evaluated by a spinal cord MRI. We discuss the role of the spinal cord radiographic study in the diagnosis, the etiopathogeny of cobalamin deficiency and the benefit of vitamin supplementation even at a late stage of the disease in geriatrics patients. CONCLUSION: The spinal cord MRI is useful in the diagnosis of late-form combined spinal cord degeneration. The high frequency of atrophic gastritis in elderly prevents the identification of a deficiency of the cobalamin etiology. The treatment relies on vitamin therapy even in the late stages. The severe disability of cobalamin deficiency neurological complications must encourage an earlier diagnosis in elderly patients.
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