维生素B12缺乏所致白质脑病
White matter disorder due to vitamin B12 deficiency
- 层级
- 5 级
定义
40%的B12缺乏症患者有神经学特征。亚急性联合变性是维生素B12缺乏的潜在可逆性神经系统并发症。症状发展隐匿，神经病理性表现包括远端进行性易感症、麻木、步态共济失调和下肢本体感觉减退，而脊髓病成分由于锥体束功能障碍导致可变运动损害。肠和膀胱失禁伴阳痿和体位性低血压是脊髓病的一部分。中枢表现包括精神错乱、抑郁、进行性幻觉和思维迟钝。也可能存在视神经病变。
Neurological features occur in 40% of patients with B12 deficiency. Subacute combined degeneration is a potentially reversible neurological complication of a vitamin B12 deficiency. Symptoms develop insidiously and neuropathic manifestations include progressive paraesthesia distally, numbness, gait ataxia and diminished proprioception in the lower limbs, while the myelopathic component leads to variable motor impairment due to pyramidal tract dysfunction. Incontinence of bowel and bladder with impotence and postural hypotension occur as part of the myelopathy. Central manifestations include confusion, depression, progressive hallucination and mental slowing. There may also be optic neuropathy present.
MRI扫描可显示广泛的白质改变，这可能与疾病进展融合，最终导致白质脑病。脊髓背柱内对称性T2高信号在脊髓亚急性联合变性患者中很常见，颈椎呈线性，胸椎呈结节状。脊髓亚急性联合变性的病理变化包括脊髓白质的海绵状改变、髓鞘局灶性丢失，局灶性髓鞘脱失和轴突破坏，尤其影响颈椎和上胸椎脊髓的后柱和侧柱。
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- 维生素B12缺乏所致白质脑病
英文词条（1）
- White matter disorder due to vitamin B12 deficiency
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