In our first installment, we will be looking at a 76 year old woman who presents to the clinic with tingling along her spine on forward flexion of the neck. She also states that she has been having numbness and pins and needles in her appendages for the past 3 months.
She mentions a progressive difficulty in the memorization of certain things, and has an unsteady gait. After being examined, it is determined that she cannot walk steadily in the dark.
These symptoms are textbook to nerve regression which is customary in people of her age. However, just to make sure, a Sagittal T2-weighted magnetic resonance imaging, or as we know it, an MRI is taken.
These were the results:
Those arrows point to a hyperintense signal in the dorsal spinal cord, or a bunch of nerves overacting. This clump stretches from her C2 to her C5, or simply for a very long stretch.
Her blood tests show a B12 deficiency, in fact her B12 level was so low it was below detectable range.
She responded well to B12 injections, and in 6 months she showed immense strides in improving her memory, balance, and sensory function.