Irreversible subacute sclerotic combined degeneration of the spinal cord in a vegan subject

Nutrition. 2007 Jul-Aug;23(7-8):622-4. doi: 10.1016/j.nut.2007.05.006.

Abstract

Objective: We describe a case of irreversible subacute sclerotic combined degeneration of the spinal cord in a Western vegan subject.

Methods: A 57-y-old man, member of a vegan cult for 13 y, developed weakness, paraplegia, hyper-reflexia, distal symmetric muscular hypotrophy, impairment of superficial sensation in the hands and feet, loss of deep sensation in the lower limbs, and neurogenic bladder and bowel. Magnetic resonance imaging of the cervical and dorsal spine disclosed abnormally increased signal intensity on T(2)-weighted sections in the posterior and lateral columns. Subacute sclerotic combined degeneration of the spinal cord was diagnosed and treatment with cobalamin was started.

Results: Despite rehabilitative treatment, the patient developed spastic hypertonia with mild improvement of paresthesias. Six months later, vitamin B12 plasma levels and hematological analysis were normal. One year later, spastic paraplegia was still present and the patient was unable to walk despite improvement on magnetic resonance imaging.

Conclusion: Irreversible subacute sclerotic combined degeneration of the spinal cord is a rare but possible effect of a strict vegetarian diet.

Publication types

  • Case Reports

MeSH terms

  • Diet, Vegetarian*
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neurodegenerative Diseases / diagnosis*
  • Neurodegenerative Diseases / drug therapy
  • Neurodegenerative Diseases / etiology
  • Spinal Cord / pathology*
  • Spinal Cord Diseases / diagnosis*
  • Spinal Cord Diseases / drug therapy
  • Spinal Cord Diseases / etiology
  • Vitamin B 12 / therapeutic use
  • Vitamin B 12 Deficiency / complications*
  • Vitamin B 12 Deficiency / drug therapy
  • Vitamin B Complex / therapeutic use

Substances

  • Vitamin B Complex
  • Vitamin B 12