title: Subacute ascending numbness.
abstract: A 21-year-old male presented with two weeks of ascending numbness involving all 4 limbs, and imbalance when walking. Examination revealed diminished vibration and proprioception at the fingers, toes, and ankles, a high steppage gait and a positive Romberg sign. He had no weakness in any muscle groups. Laboratory data included vitamin B12 218 pg/mL (normal range: 200-800 pg/mL), homocysteine 87 μmol/L (normal range: 2.2-13.2 μmol/L), and non-reactive RPR. Magnetic resonance imaging of the cervical spine revealed abnormal T2-weighted hyperintensity along the posterior columns extending from C2 to C7.
authors.affiliation: Department of Neurology, University of Southern California , Los Angeles, CA , USA.
authors.forename: B
authors.initials: B
authors.lastname: Arshi
authors.forename: S
authors.initials: S
authors.lastname: Shaw
mesh_terms: D006710:Homocysteine / Q000097:blood; D006801:Humans; D006987:Hypesthesia / Q000139:chemically induced / Q000473:pathology*; D013287:Illicit Drugs / Q000633:toxicity; D019570:Inhalation Exposure; D008279:Magnetic Resonance Imaging; D008297:Male; D009609:Nitrous Oxide / Q000633:toxicity*; D011434:Proprioception / Q000187:drug effects; D013116:Spinal Cord / Q000187:drug effects / Q000473:pathology; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000097:blood; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D006710:Homocysteine; D009609:Nitrous Oxide; D014805:Vitamin B 12
keywords: CNS and psychological; CNS/Psychological; Metabolic