Document Type

Article

Publication Date

7-28-2023

Publication Title

Cureus

Keywords

spastic paresis, proprioception, vit b12 deficiency, folate deficiency, subacute combined degeneration

ISSN

2168-8184

Volume

15

Issue/No.

7

First Page

e42593

Abstract

Folate deficiency is a rare cause of subacute combined degeneration (SCD). SCD is characterized by demyelination of the dorsal and lateral columns of the cervical and thoracic spine most commonly caused by vitamin B12 deficiency. Folate deficiency, which can be clinically indistinguishable from B12 deficiency, leads to a variety of presentations, including absent vibratory sensation and proprioception, sensory ataxia, and progressive motor weakness. Recognizing the clinical sequelae of SCD is essential for timely diagnosis and treatment. We present a case of a 38-year-old male with progressive ascending bilateral lower extremity numbness and motor weakness in the presence of normal vitamin B12 and methylmalonic acid levels. MRI of the entire neuraxis revealed a diagnosis of SCD, which was managed with oral folate replacement. We aim to highlight this rare cause of SCD, which can lead to permanent neurological deficits if not promptly recognized and treated.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

DOI

10.7759/cureus.42593

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