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Subacute combined degeneration

Alternative Names: Subacute combined degeneration of the spinal cord; SCD Symptoms: abnormal sensations of the legs, arms, trunk, or other area tingling, "pins and needles", or "shock-like" sensations numbness these symptoms progressively worsen usually symmetrical (on both sides of the body) weakness of the legs, arms, trunk, or other area progressively worsens usually symmetrical unsteady gait clumsiness, stiff, or awkward movements change in mental state irritability apathy sleepiness suspiciousness, paranoia confusion, disorientation, delirium depression dementia, intellectual deterioration vision changes decreased vision Speech impairment may also be associated with this disease. Signs and tests: Text Continues Below An examination usually shows symmetrical (on both sides of the body)  sensorimotor polyneuropathy, with muscle weakness and sensation disturbance. Reflexes are often abnormal. Muscles may develop spasticity. There is a loss of awareness of body position, and sense of touch, pain, and temperature may be diminished. Mental changes are variable, from mild forgetfulness to complete dementia or psychosis. Severe dementia is uncommon, but in some cases, it is the initial symptom of the disorder. An eye examination may indicate damage to the optic nerve (optic neuritis ), with abnormal pupil responses, inflammation or atrophy of the optic nerve (visible on retinal exam), decreased visual acuity, and other changes. CBC (complete blood count) may show anemia. If folic acid has been used to treat anemia, neurologic symptoms may develop even if the anemia is no longer evident and this may make diagnosis difficult. Serum (blood) levels of vitamin B-12 are low.

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