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Neurology (Expert Forum)
Conuing Sub-Acute Combined Degeneration of Spinal Cord?
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Conuing Sub-Acute Combined Degeneration of Spinal Cord?
by patches748, Jan 05, 2002 12:00AM
I was diagnosed sub-acute combined degeneration of the spinal cord in February of 1999 and have getting B-12 shots since. but what ever is wrong with me is slowly progressing.
I startd complaining about burning in my feet in 1996. In 1997 I was complaining of occasional falling by and exam at VA showed some atrohy of one optic nerve. But was not tested until 1999 (for MS and that was ruled out)but B-12 level was 294 (they only did B-12 test level). I had an abnormal visual evoked test, positive Romberg and my EMG showed moderate to severe neuropathy (axonal and sensory-motor damage). The shots seemed to help at first but problems are continuing. In eye exam in 2001 I had atrophy in both optic nerves and loss of visual acuity causing constant blurriness in both eyes.
Now I have a new problem starting with muscle jerking. I will take a step and the my leg with jerk down which causes me to fall. My arms do the same thing and this type if jerking occurs when trying to make some kind of movement. I have also been diagnosed with fibromyalgia. Plus suffered from two severe whiplashes in 1989 and 1991, and two head injuries (with back of head hitting concrete in 1996 and falling down 11 concrete steps in 1999. After the two head injuries my migraines increased, have had many more problems with ability to think clearly (including doing my checking account) getting lost, etc.
Is it possible my B-12 deficiency is not improving with the shots? Or could something else be going on? I am desperate for answers as this is pretty scarey to me with this progression.
I startd complaining about burning in my feet in 1996. In 1997 I was complaining of occasional falling by and exam at VA showed some atrohy of one optic nerve. But was not tested until 1999 (for MS and that was ruled out)but B-12 level was 294 (they only did B-12 test level). I had an abnormal visual evoked test, positive Romberg and my EMG showed moderate to severe neuropathy (axonal and sensory-motor damage). The shots seemed to help at first but problems are continuing. In eye exam in 2001 I had atrophy in both optic nerves and loss of visual acuity causing constant blurriness in both eyes.
Now I have a new problem starting with muscle jerking. I will take a step and the my leg with jerk down which causes me to fall. My arms do the same thing and this type if jerking occurs when trying to make some kind of movement. I have also been diagnosed with fibromyalgia. Plus suffered from two severe whiplashes in 1989 and 1991, and two head injuries (with back of head hitting concrete in 1996 and falling down 11 concrete steps in 1999. After the two head injuries my migraines increased, have had many more problems with ability to think clearly (including doing my checking account) getting lost, etc.
Is it possible my B-12 deficiency is not improving with the shots? Or could something else be going on? I am desperate for answers as this is pretty scarey to me with this progression.
Doctor's Answer
by CCF-Neuro-M.D.-JT, Jan 05, 2002 12:00AM
Sorry to hear about your symptoms. First, there is an association between the spinal cord problem as well as optic atrophy related to B12 deficiency, so it's possible your symptoms are all from that. Cyanide posioning as well as abnormal metabolism of cyanide can also cause these symptoms (cyanide level can be easily checked in the blood). Your B12 deficiency needs to be fully evaluated with serial followup lab checks. Another lab that they can check is called methylamalonic acid, a biochemical compound in your body that will be high if B12 is not properly metabolized.
Second, your spinal cord also needs to be closely evaluated. I agree, this could be something else. There are diseases that can cause primary spinal cord problems like paralysis in association with optic atrophy of both eyes such as Devic's syndrome, a disease that is similar to MS, but usually does not involve the brain. I would suggest an MRI of the spine.
Finally, the jerks that you describe could be spasms of your limbs due to abnormal spinal cord input. It would be important for a neurologist to take a look at you and see if they are indeed spasms. Medications like baclofen can be of help in that case.
I understand your concern, especially since everything seems to be progressing without any real answers or improvement. What;s important for you now is to find a good neurologist near you to help you determine what's going through a proper diagnostic workup and examination. Or get a second opinion from a major academic or clinical center. I wish you the best of luck.
Second, your spinal cord also needs to be closely evaluated. I agree, this could be something else. There are diseases that can cause primary spinal cord problems like paralysis in association with optic atrophy of both eyes such as Devic's syndrome, a disease that is similar to MS, but usually does not involve the brain. I would suggest an MRI of the spine.
Finally, the jerks that you describe could be spasms of your limbs due to abnormal spinal cord input. It would be important for a neurologist to take a look at you and see if they are indeed spasms. Medications like baclofen can be of help in that case.
I understand your concern, especially since everything seems to be progressing without any real answers or improvement. What;s important for you now is to find a good neurologist near you to help you determine what's going through a proper diagnostic workup and examination. Or get a second opinion from a major academic or clinical center. I wish you the best of luck.
Since 3 to 4 months, I have been diagnosed as SCD.
I was a fit absolutely alright individual before this.
incidently I started getting tingling in both my hands,
especially the fingertips.
my fingergrips started becomming loose.
initially every body thought of cord compression.
but my MR study(cervical) revealed-
1>no cord compression.
2>altered cord signals(sagitals)
3>posterior column enhancement(axialT2)
suggestive of Subacute combined degeneration of cord.
My low B12levels confirmed the diagnosis.
&since then ive been put on Inj.B12.
1]my symptoms have not reduced to a great extent.
2]Is this desease really curable with proper treatment as books mention?
3]Is there any relation bet.EXPOSURE TO N2O & SACD?
thanq all.