clinical features
Last reviewed 01/2018
The clinical features of subacute combined degeneration of the spinal cord are based on:
- symmetrical loss of posterior columns causing an ataxic gait
- symmetrical upper motor neurone signs in the lower limbs with absent reflexes
- other features:
- peripheral sensory neuropathy
- optic atrophy
- dementia
Symptoms may include:
- paraesthesiae
- unsteadiness; perhaps severe enough to prevent walking
- weakness
- stiffness of legs
Signs include:
- spasticity in legs
- hyporeflexia at the knees
- loss of ankle jerks
- extensor plantar responses
- impaired posterior column function
NB: there may also be a sphincter disturbance with a dilated hypotonic bladder and a loss of sense of bladder fullness.