Presentation
One week of progressive weakness and paresthesia in limbs. History of abuse of nitrous oxide.
Patient Data
There is a lesion characterized by a diffuse, symmetric, bilateral high T2 signal within the dorsal columns of the spinal cord, forming an inverted V shape. Additionally, there is a mild enhancement, with the lesion extending from the level of C1 to the level of T1.
Case Discussion
The findings are most likely indicative of subacute combined degeneration of the cord. It's worth noting that mild enhancement, while not typically expected, has been reported in some studies. Additionally, the patient had a history of recreational nitrous oxide use.
After one week of treatment with a high dose of vitamin B12, there was a notable improvement in the patient's symptoms.
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