altered gait, no diagnosis

[linda529]

Hello,  my mom is a healthy active 60yo white american who has had on and off symptoms for about 5 months with no diagnosis.
Her symptoms were just vague at first (sleeplessness, fatigue, leg pain and burning sensation, increased headaches (has hx of migraines)).  
More recently in last 3 months she has very unsteady gait with no dizziness, it comes and goes, she never knows when it is going to hit her.  She is fine sitting and laying but not when standing.
She is now unable to perform her day to day tasks and often cannot go to the gym to workout because the unsteadiness is so severe.  When she saw her GP MD he did bloodwork and MRI of brain, all unremarkable except for a slightly low B12 level.   She thought this was the answer and got started on a regimen of shots and was referred to a neurologist.  The neurologist performed a number of physical assessment tests on her, most of which she failed dealing with standing with feet together, one foot, etc...  The neurologist did a nerve conduction study on her legs which was fine.  He has said let's wait and see with the shots how she progresses.  She has some good days but more often not.  She has revisited the neurologist and he is now odering a MRI of the neck and some copper studies to check absorption issues?   I am concerned because my mom lives in a rural area and am not confident with the resources available there.  Any ideas on possible diagnosis?
Thank you.

[linda529]

Wouldn't these symptoms be improving with having the daily, now the weekly shots for about 6 weeks?

She just had a cervical MRI on Tues this week, no results yet.  But even if it's SACD would the treatment be any different?

Does the severe torso cramping she experiences part of the B12 deficiency?  Her level was 238 initially and has not been repeated since therapy began.
Thanks for the info.

[Abhijeet Deshmukh, MD]

Hello.

With the blood work showing B12 deficiency, a spinal cord MRI should have been done to find out lesions of Subacute Combined Degeneration of the Cord (SACD). The symptoms of SACD can reduce with B12 supplementation.

The disease strikes the dorsal columns of the spinal cord. these are concerned with balance. The MRI may show symmetric hyperintense lesions on the posterior spinal cord.

Regards

[linda529]

I forgot to also say that she has been experiencing cramps in her abdominal area and around her ribs, very painful cramps.  Any help is much appreciated.