COBALAMIN DEFICIENCY : SUBACUTE COMBINED DEGENERATION OF SPINAL CORD

Vitamin B12 (Cobalamin) deficiency can lead to neurological complications, including Subacute Combined Degeneration (SCD) of the spinal cord, primarily affecting the dorsal and lateral columns. This case report describes a 74-year-old postmenopausal female with progressive lower limb weakness, imbalance, and urinary incontinence. Neurological examination revealed spastic ataxic gait, impaired vibration and proprioception, and atrophy of hand muscles. Blood tests showed macrocytic anemia and low vitamin B12 levels (<50 pg/mL). MRI spine imaging revealed an "Inverted V" sign, indicative of bilateral dorsal column changes. The patient was treated with intravenous Methylprednisolone and folic acid, leading to gradual improvement. Vitamin B12 deficiency can arise from dietary insufficiency, pernicious anemia, or gastrointestinal disorders. Early diagnosis and treatment with B12 supplementation are crucial to prevent irreversible neurological damage. Regular monitoring of vitamin B12 levels is recommended in high-risk populations, including vegetarians, those with gastrointestinal surgeries, or nitrous oxide use.