Turkish Journal of Physical Medicine and Rehabilitation
2016 , Vol 62 , Num 4
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Progressive subacute combined degeneration: a severe relapse with discontinuation of vitamin B12 treatment
1 Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
2 Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
3 Department of Physical Medicine and Rehabilitation, Bağcılar Training and Research Hospital, İstanbul, Turkey
Subacute combined degeneration is a rare clinical manifestation characterized by dysesthesia, deep sensory impairment and spastic paraparesis.
A 62-year-old male patient was admitted to the outpatient clinic with the complaint of difficulty in walking. We detected he had position and
vibration loss in all extremities, bilateral weakness in legs, spasticity and increase in deep tendon reflexes. History of the patient revealed that he
was previously examined in a neurology clinic for sensory disturbance and his complaints declined after vitamin B12 deficiency was detected
and treated. Following the discontinuation of treatment, we took the patient admitted to our clinic with spastic paraplegia to the inpatient
physical therapy program and we applied B12 replacement; we follow-up the patient who can ambulate with the aid of a walker upon discharge.
Paraparesis; subacute combined degeneration; vitamin B12