Subacute combined degeneration of the spinal cord

Question 1

Deficiency of what vitamin causes subacute degeneration of the spinal cord?

Answer 1

Vitamin B12

Question 2

What tracts are affected by Subacute degeneration of the cord?

Answer 2

dorsal columns
- virbation/proprioception

lateral corticospinal tracts
- spastic paresis

spinocerebellar tracts
- limb ataxia

Question 3

Clinical features which indicate dorsal column involvement

Answer 3

Symmetrical distal tingling/burning/sensory loss

affects legs > arms

impaired proprioception and vibration sense

Question 4

Clinical features which indicate lateral corticospinal tract involvement

Answer 4

muscle weakness
hyperreflexia
spasticity
brisk knee reflexes
absent ankle jerks
extensor plantars

Question 5

Clinical features indicating spinocerebellar tract abnormalities

Answer 5

sensory ataxia → gait abnormalities
positive Romberg’s sign