What is subacute combined degeneration of the spinal cord?
Subacute combined degeneration of the spinal cord is the result of vitamin B12 deficiency.
Most patients with B12 deficiency will present with a peripheral neuropathy that causes a burning, painful sensation in their hands and feet.
Examination shows a stocking-glove sensory loss as well as vibratory loss. However, if the spinal cord is affected, it results in demyelination and vacuolar degeneration of the posterior columns and corticospinal tracts.
This results in upper motor neuron signs of weakness, increased tone, hyperreflexia, and Babinski’s and Hoffmann’s signs.
Nitrous oxide exposure may produce a similar pathologic picture.
Treatment is with intramuscular B12 replacement.
