26B. Subacute combined degeneration of the spinal cord (funicular myelosis)

Definition and epidemiology

Subacute combined degeneration of the spinal cord, also called funicular myelosis, is a degeneration of the dorsal and lateral white matter of the spinal cord which occurs due to chronic B12 deficiency.

The spinocerebellar, lateral corticospinal, and dorsal columns are affected.

Clinical features

The patient has loss of deep sensation, vibration, and position sense. Sensory ataxia is also present.

Diagnosis and evaluation

Megaloblastic anaemia may be present, as well as low serum B12 and high MMA and homocysteine.

Treatment

Treatment is B12 supplementation. It may take a long time for the symptoms to improve, and they may not completely resolve.


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26A. Symptoms of insufficient blood circulation in vertebrobasilar territory

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27A. Ischemic stroke

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