title: Ataxic gait following total gastrectomy for gastric cancer.
abstract: A 58-year-old woman, who had undergone total gastrectomy for early gastric cancer 9 years previously, visited the outpatient clinic complaining of progressive difficulty in walking for 15 d. Laboratory examinations showed macrocytic anemia and a decreased serum vitamin B12 concentration and increased serum concentrations of folate, vitamin E and copper. Magnetic resonance imaging showed multifocal high signal intensities along the posterior column of the cervical and thoracic spinal cord. Treatment consisted of intramuscular injections of vitamin B12 for 7 d, which increased her serum level of vitamin B12 to normal. This was followed by weekly intramuscular injections of vitamin B12 for another 2 wk and oral administration of vitamin B12 three times per day. After comprehensive rehabilitation for 4 wk, she showed sufficient improvements in strength and ataxic gait, enabling her to return to her normal daily activities.
authors.affiliation: Chang Ho Hwang, Department of Physical Medicine and Rehabilitation Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, South Korea.
authors.forename: Chang Ho
authors.initials: CH
authors.lastname: Hwang
authors.affiliation: Chang Ho Hwang, Department of Physical Medicine and Rehabilitation Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, South Korea.
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Park
authors.affiliation: Chang Ho Hwang, Department of Physical Medicine and Rehabilitation Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, South Korea.
authors.forename: Gyu Yeol
authors.initials: GY
authors.lastname: Kim
mesh_terms: D000284:Administration, Oral; D001259:Ataxia / Q000150:complications* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005684:Gait; D005743:Gastrectomy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency; D016138:Walking
chemical_list: D014805:Vitamin B 12
keywords: Gastric cancer; Subacute combined degeneration; Total gastrectomy; Vitamin B12 deficiency