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- W2582641098 abstract "Setting: Outpatient clinic. Patient: A 52-year-old woman with C6 American Spinal Injury Association (ASIA) grade D tetraplegia. Case Description: 4 years prior to presentation, the patient sustained tetraplegia secondary to a fall. Neurologically, she had progressive return to a C6 ASIA grade D tetraplegia. Approximately 2 months prior to presentation, she began experiencing a marked increase in neuropathic pain, which radiated into her arms, and was described as burning with pins and needles dyesthesias. In addition, she noticed an increase in spasticity with clawing of her left hand, as well as left-sided greater than right-sided weakness, and with consequent functional impairments. The patient’s initial presentation was concerning for a posttraumatic syringomyelia and magnetic resonance imaging (MRI) was ordered. MRI compared with initial postinjury MRI was unchanged and failed to document a syrinx. Subsequent laboratory studies included thyroid function tests, as well as B12 and folate levels. Assessment/Results: Her B12 level was found to be low and on further questioning, the patient’s mother had a diagnoses of B12 deficiency for which she received monthly B12 injections, unbeknownst to the patient. The patient was placed on intramuscular B12 injections with return of serum levels to normal and subsequent quick resolution of all of her symptoms. Discussion: This is the first reported case that we know of a chronic spinal cord injury (SCI) patient having a superimposed subacute combined deficiency, which presented similar to syringomyelia. Conclusions: Subacute combined deficiency can present similar to a syringomyelia in the chronic SCI patient and should be part of the differential diagnosis considered." @default.
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- W2582641098 date "2005-09-01" @default.
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- W2582641098 title "Poster 219" @default.
- W2582641098 doi "https://doi.org/10.1016/j.apmr.2005.07.242" @default.
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