Objective: To observe the presentations and in the patients with subacute combined degeneration (SCD) changes of electrophysiology (EP) and magnetic resonance image (MRI) before and after treatment and to analyze their values in diagnosis.
Methods: 10 patients received a series of examinations, including clinical neurological functions, serum vitamin B12 and folic acid concentrations, spinal cord MRI, peripheral nerve conduction velocity, sensory evoked potential (SEP) and visual evoked potential(VEP). They were followed up for 3 to 36 months. The changes of spinal cord MRI and SEP before and after the treatment were studied.
Results: After Vitamin B12 therapy, all the patients improved,but there were still some abnormalities of SEP left. The lesions could be shown sensitively by EP. The changes of SEP and clinical symptoms correlated with each other. The spinal cord MRIs of most patients showed the lesions objectively, demonstrating primarily long-tape abnormal signals in posterior and lateral columns, iso-intense on T1 and hyper-intense on T2 without contrast. Most lesions were seen at the thoracic cord. The lesions constricted or disappeared when the clinical conditions improved.
Conclusion: Spinal cord MRI and EP could objectively show the lesions of SCD and the change before and after the treatment. These examinations and the follow-up of disease could be helpful in the diagnosis of SCD.