A Case of Combined Compressive and Vitamin B12 Deficient Myelopathy: A case report

ABSTRACT

Vitamin B12 deficiency can cause myelopathy of subacute combined degeneration of lateral and dorsal column in spinal cord. When combined with compressive myelopathy, symptoms and signs of vitamin B12 deficient myelopathy could be masked. We experienced a case of forty-one year old man suffered from gait disturbance and decreased proprioception. Initially surgeons concluded his weakness resulted from myelopathy by C5-6 centrally herniated disk based on MRI and surgical decompression was performed. Gait disturbance slightly improved but decreased proprioception did not improve. Vitamin B12 deficiency was found and high signal intensity lesions were found in dorsal and lateral spinal column with review of pre-op MRI. After administration with vitamin B12 supplements, weakness and sensation of proprioception improved and follow-up MRI showed decreased signal intensity. We concluded the cause of his symptoms was combination of compressive myelopathy and vitamin B12 deficient myelopathy.