Subacute combined degeneration of cord - Vit B12 deficiency
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42 year old female presented for MRI with long standing neck pain and recent onset tingling numbness in hands and feet.
Patient is a pure vegetarian. The present symptoms appeared two months after she excluded milk from her diet.
Vit B12 levels were subsequently found to be low. (30 pcg)
MRI shows classic posterior spinal cord hyperintensity - typical of posterior column involvement of SACD.