Motooka Rieko, Yamamoto Shinji
Depertment of Neurology, Kobe Red Cross Hospital.
Rinsho Shinkeigaku. 2016 Oct 28;56(10):690-693. doi: 10.5692/clinicalneurol.cn-000926. Epub 2016 Oct 16.
We report a 39-year-old woman with slowly progressive spastic gait and paresthesia in the lower extremities. Cervical spinal MRI revealed high intensity in the dorsal column from vertebrae C2 to C7. Laboratory findings showed normal vitamin B12 and low serum copper level. By lifestyle history taking, we noticed her extreme unbalanced diet of having 15-20 oysters everyday over 5 years. Then we considered that zinc excess caused copper deficiency myelopathy. We needed to pay attention to copper and zinc level if the patient has a symptom resembling subacute combined degeneration of spinal cord with normal serum vitamin B12.
我们报告了一名39岁女性,她患有缓慢进展的痉挛性步态和下肢感觉异常。颈椎MRI显示C2至C7椎体的背柱有高强度信号。实验室检查结果显示维生素B12正常,血清铜水平低。通过询问生活方式史,我们注意到她在5年多的时间里每天食用15 - 20个牡蛎,饮食极度不均衡。然后我们认为锌过量导致了铜缺乏性脊髓病。如果患者出现类似脊髓亚急性联合变性且血清维生素B12正常的症状,我们需要关注铜和锌的水平。