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Medicine General a20221c2

All are true about subacute combined degeneration of spinal cord except :

A
Due to deficiency of vitamin B12
B
Posterior column involvement
C
Coicospinal involvement
D
Absent deep tendon reflexes
High-Yield Explanation
Answer is D (Absent deep tendon reflexes): Subacute Combined Degeneration Of Cord is a condition of the spinal cord characterized by demyelination of its neurons due to deficiency of Vit B12 which results in defective/ deficient myelination. Such demyelination occurs predominantly in - Posterior column of spinal cord - Pyramidal tract of spinal cord Subacute Combined Degeneration Of Cord is characterized by involvement of: Posterior column of lower cervical & upper thoracic region This is where changes commence. Paraesthaesias, consisting of tingling & numbness and that of pins & needles Q * Loss of vibration sense Q * Position sense is involved to a lesser extent. Q * Ataxic gait Lateral columns (coicospinal tracts) Their involvement follows the involvement of post columns. Motor defects such as weakness and spasticity Q Increased deep tendon reflexes, clonusQ Plantar extensor Q Spastic gait (Note that gait is initially ataxic but later becomes both spastic and ataxic. Q(at an early stage patellar & achilles reflexes may be diminished, increased or absent).

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