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Medicine C.N.S. dea13b1e

65 year old man presents with anaemia and posterior column dysfunction, the likely cause is:

A
B1-deficit
B
B12-deficit
C
SSPE
D
Multiple sclerosis
High-Yield Explanation
Ans. is 'b' Vit. B12 deficit (Ref Harrison, 16/e, p 2458 (15/e, p 2432)).Patient with anaemia and post, column dysfunction is most likely suffering from subacute combined degeneration of the cord. (SACD)SACD occurs due to vitamin B12 deficiency.Vitamin B12 deficiency leads to megaloblastic anaemia and defects in myelination. Demyelination occurs in predominantly post-column* and pyramidal tract* and later in the course peripheral nerves are also involved.

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