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KMID : 0860920110130010087
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2011 Volume.13 No. 1 p.87 ~ p.90
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Subacute Combined Degeneration manifesting as Spastic Paraplegia in Cronh’s Disease Patient: A Case Report
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Park Eun-Kyung
Lee Kyu-Sun
Kim Sung-Hee
Yang Hye-Ran
Kim Jee-Young
Park Kee-Duk
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Abstract
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Subacute combined degeneration (SCD) is a spinal cord disorder involving posterior and lateral columns
due to vitamin B12 deficiency. We report a case of 39-year-old male with known Crohn’s disease and
subsequent ileocecectomy, who showed progressive spastic paraplegia. Neurologic examination revealed
predominant feature of spastic paraplegia with scissor gait and bilateral hyperreflexia, associated with
psychomotor slowing, poor vibration sense of both distal legs. Spinal MRI revealed high signal intensities
in upper thoracic spinal cord, and tibial SEP revealed central conduction delays. VEP study showed bilateral
prolonged P100 latencies. Serum vitamin B12 level was low (191.9 pg/mL). After parenteral administration
of vitamin B12, his neurologic symptoms rapidly improved. His neurologic symptoms are
believed to be the result of vitamin B12 deficiency due to previous ileocecectomy. Vitamine deficiency
should be ruled out as a cause of neurologic complications in patients with malabsortive condition even
when the neurological manifestation is atypical.
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KEYWORD
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Spastic paraplegia , Vitamin B12 deficiency , Subacute combined degeneration , Crohn’s disease
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