Subacute combined degeneration of the cord

Subacute combined degeneration of the cord is caused by vitamin B12 deficiency. The early signs usually include loss of vibration sense and position sense. There is usually a symmetrical peripheral neuropathy, which is associated with absence of ankle reflexes. The sensory ataxia leads to a positive Rhomberg's sign. Knee reflexes are often brisk and plantars are extensor due to pyramidal involvement causing upper motor signs.

Vitamin B12 deficiency may also cause optic atrophy and confusion.

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