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Subacute Combined Degeneration
Lubdha M. Shah, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Subacute combined degeneration (SCD)
              • Synonyms

                • Combined system disease
              • Definitions

                • Vitamin B₁₂ deficiency produces selective degeneration of dorsal ± lateral spinal cord columns

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Other Modality Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Schwendimann RN: Metabolic, nutritional, and toxic myelopathies. Neurol Clin. 31(1):207-18, 2013
                                            2. Kumar N: Metabolic and toxic myelopathies. Semin Neurol. 32(2):123-36, 2012
                                            3. Lim CC: Neuroimaging in postinfectious demyelination and nutritional disorders of the central nervous system. Neuroimaging Clin N Am. 21(4):843-58, viii, 2011
                                            4. Jaiser SR et al: Copper deficiency myelopathy. J Neurol. Epub ahead of print, 2010
                                            5. de Lau LM et al: Plasma vitamin B12 status and cerebral white-matter lesions. J Neurol Neurosurg Psychiatry. 80(2):149-57, 2009
                                            6. Puntambekar P et al: Rare sensory and autonomic disturbances associated with vitamin B12 deficiency. J Neurol Sci. 287(1-2):285-7, 2009
                                            7. Tan IY et al: Hypocupremia: an under recognized cause of subacute combined degeneration. Can J Neurol Sci. 36(6):779-82, 2009
                                            8. Misra UK et al: Bladder dysfunction in subacute combined degeneration: a clinical, MRI and urodynamic study. J Neurol. 255(12):1881-8, 2008
                                            9. Senol MG et al: Reversible myelopathy with vitamin B12 deficiency. Singapore Med J. 49(11):e330-2, 2008
                                            10. Goodman BP et al: Copper deficiency myeloneuropathy resembling B12 deficiency: partial resolution of MR imaging findings with copper supplementation. AJNR Am J Neuroradiol. 27(10):2112-4, 2006
                                            11. Teplitsky V et al: Hereditary partial transcobalamin II deficiency with neurologic, mental and hematologic abnormalities in children and adults. Isr Med Assoc J. 5(12):868-72, 2003
                                            12. Ilniczky S et al: MR findings in subacute combined degeneration of the spinal cord caused by nitrous oxide anaesthesia--two cases. Eur J Neurol. 9(1):101-4, 2002
                                            13. Srikanth SG et al: MRI in subacute combined degeneration of spinal cord: a case report and review of literature. Neurol India. 50(3):310-2, 2002
                                            14. Ravina B et al: MR findings in subacute combined degeneration of the spinal cord: a case of reversible cervical myelopathy. AJR Am J Roentgenol. 174(3):863-5, 2000
                                            15. Locatelli ER et al: MRI in vitamin B12 deficiency myelopathy. Can J Neurol Sci. 26(1):60-3, 1999
                                            16. Beltramello A et al: Subacute combined degeneration of the spinal cord after nitrous oxide anaesthesia: role of magnetic resonance imaging. J Neurol Neurosurg Psychiatry. 64(4):563-4, 1998
                                            17. Hemmer B et al: Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry. 65(6):822-7, 1998
                                            18. Katsaros VK et al: MRI of spinal cord and brain lesions in subacute combined degeneration. Neuroradiology. 40(11):716-9, 1998
                                            19. Pema PJ et al: Myelopathy caused by nitrous oxide toxicity. AJNR Am J Neuroradiol. 19(5):894-6, 1998
                                            20. Yamada K et al: A case of subacute combined degeneration: MRI findings. Neuroradiology. 40(6):398-400, 1998
                                            21. Larner AJ et al: MRI appearances in subacute combined degeneration of the spinal cord due to vitamin B12 deficiency. J Neurol Neurosurg Psychiatry. 62(1):99-100, 1997
                                            22. Weir DG et al: The biochemical basis of the neuropathy in cobalamin deficiency. Baillieres Clin Haematol. 8(3):479-97, 1995
                                            23. Murata S et al: MRI in subacute combined degeneration. Neuroradiology. 36(5):408-9, 1994
                                            24. Timms SR et al: Subacute combined degeneration of the spinal cord: MR findings. AJNR Am J Neuroradiol. 14(5):1224-7, 1993
                                            25. Tracey JP et al: Magnetic resonance imaging in cobalamin deficiency. Lancet. 339(8802):1172-3, 1992
                                            26. Berger JR et al: Reversible myelopathy with pernicious anemia: clinical/MR correlation. Neurology. 41(6):947-8, 1991
                                            27. Healton EB et al: Neurologic aspects of cobalamin deficiency. Medicine (Baltimore). 70(4):229-45, 1991
                                            28. Petito CK et al: Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. N Engl J Med. 312(14):874-9, 1985
                                            29. Crampton RF et al: Effects of low cobalamin diet and chronic cyanide toxicity in baboons. Toxicology. 12(3):221-34, 1979
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Subacute combined degeneration (SCD)
                                                        • Synonyms

                                                          • Combined system disease
                                                        • Definitions

                                                          • Vitamin B₁₂ deficiency produces selective degeneration of dorsal ± lateral spinal cord columns

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Other Modality Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Schwendimann RN: Metabolic, nutritional, and toxic myelopathies. Neurol Clin. 31(1):207-18, 2013
                                                                                      2. Kumar N: Metabolic and toxic myelopathies. Semin Neurol. 32(2):123-36, 2012
                                                                                      3. Lim CC: Neuroimaging in postinfectious demyelination and nutritional disorders of the central nervous system. Neuroimaging Clin N Am. 21(4):843-58, viii, 2011
                                                                                      4. Jaiser SR et al: Copper deficiency myelopathy. J Neurol. Epub ahead of print, 2010
                                                                                      5. de Lau LM et al: Plasma vitamin B12 status and cerebral white-matter lesions. J Neurol Neurosurg Psychiatry. 80(2):149-57, 2009
                                                                                      6. Puntambekar P et al: Rare sensory and autonomic disturbances associated with vitamin B12 deficiency. J Neurol Sci. 287(1-2):285-7, 2009
                                                                                      7. Tan IY et al: Hypocupremia: an under recognized cause of subacute combined degeneration. Can J Neurol Sci. 36(6):779-82, 2009
                                                                                      8. Misra UK et al: Bladder dysfunction in subacute combined degeneration: a clinical, MRI and urodynamic study. J Neurol. 255(12):1881-8, 2008
                                                                                      9. Senol MG et al: Reversible myelopathy with vitamin B12 deficiency. Singapore Med J. 49(11):e330-2, 2008
                                                                                      10. Goodman BP et al: Copper deficiency myeloneuropathy resembling B12 deficiency: partial resolution of MR imaging findings with copper supplementation. AJNR Am J Neuroradiol. 27(10):2112-4, 2006
                                                                                      11. Teplitsky V et al: Hereditary partial transcobalamin II deficiency with neurologic, mental and hematologic abnormalities in children and adults. Isr Med Assoc J. 5(12):868-72, 2003
                                                                                      12. Ilniczky S et al: MR findings in subacute combined degeneration of the spinal cord caused by nitrous oxide anaesthesia--two cases. Eur J Neurol. 9(1):101-4, 2002
                                                                                      13. Srikanth SG et al: MRI in subacute combined degeneration of spinal cord: a case report and review of literature. Neurol India. 50(3):310-2, 2002
                                                                                      14. Ravina B et al: MR findings in subacute combined degeneration of the spinal cord: a case of reversible cervical myelopathy. AJR Am J Roentgenol. 174(3):863-5, 2000
                                                                                      15. Locatelli ER et al: MRI in vitamin B12 deficiency myelopathy. Can J Neurol Sci. 26(1):60-3, 1999
                                                                                      16. Beltramello A et al: Subacute combined degeneration of the spinal cord after nitrous oxide anaesthesia: role of magnetic resonance imaging. J Neurol Neurosurg Psychiatry. 64(4):563-4, 1998
                                                                                      17. Hemmer B et al: Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry. 65(6):822-7, 1998
                                                                                      18. Katsaros VK et al: MRI of spinal cord and brain lesions in subacute combined degeneration. Neuroradiology. 40(11):716-9, 1998
                                                                                      19. Pema PJ et al: Myelopathy caused by nitrous oxide toxicity. AJNR Am J Neuroradiol. 19(5):894-6, 1998
                                                                                      20. Yamada K et al: A case of subacute combined degeneration: MRI findings. Neuroradiology. 40(6):398-400, 1998
                                                                                      21. Larner AJ et al: MRI appearances in subacute combined degeneration of the spinal cord due to vitamin B12 deficiency. J Neurol Neurosurg Psychiatry. 62(1):99-100, 1997
                                                                                      22. Weir DG et al: The biochemical basis of the neuropathy in cobalamin deficiency. Baillieres Clin Haematol. 8(3):479-97, 1995
                                                                                      23. Murata S et al: MRI in subacute combined degeneration. Neuroradiology. 36(5):408-9, 1994
                                                                                      24. Timms SR et al: Subacute combined degeneration of the spinal cord: MR findings. AJNR Am J Neuroradiol. 14(5):1224-7, 1993
                                                                                      25. Tracey JP et al: Magnetic resonance imaging in cobalamin deficiency. Lancet. 339(8802):1172-3, 1992
                                                                                      26. Berger JR et al: Reversible myelopathy with pernicious anemia: clinical/MR correlation. Neurology. 41(6):947-8, 1991
                                                                                      27. Healton EB et al: Neurologic aspects of cobalamin deficiency. Medicine (Baltimore). 70(4):229-45, 1991
                                                                                      28. Petito CK et al: Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. N Engl J Med. 312(14):874-9, 1985
                                                                                      29. Crampton RF et al: Effects of low cobalamin diet and chronic cyanide toxicity in baboons. Toxicology. 12(3):221-34, 1979