Koike Haruki, Nakamura Tomohiko, Ikeda Shohei, Takahashi Mie, Kawagashira Yuichi, Iijima Masahiro, Katsuno Masahisa, Sobue Gen
Department of Neurology, Nagoya University Graduate School of Medicine, Japan.
Intern Med. 2017;56(1):105-108. doi: 10.2169/internalmedicine.56.7364. Epub 2017 Jan 1.
A patient with chronic alcoholism presented with myelopathy and low serum folate and cobalamin levels. A 42-year-old alcoholic man had gait disturbance for 4 months. A neurological examination revealed marked spasticity with increased deep tendon reflexes and extensor plantar responses of the lower limbs. His cobalamin level was decreased and his serum folate level was particularly low. His plasma ammonia level was not increased. Abstinence and folic acid and cobalamin supplementation stopped the progression of his neurological deficits. This case indicates that nutritional deficiency should be monitored closely in patients with chronic alcoholism who present with myelopathy.
一名慢性酒精中毒患者出现脊髓病，血清叶酸和钴胺素水平较低。一名42岁的酗酒男性有4个月的步态障碍。神经系统检查显示明显的痉挛，下肢深腱反射增强和跖伸反应。他的钴胺素水平降低，血清叶酸水平特别低。他的血浆氨水平没有升高。戒酒以及补充叶酸和钴胺素阻止了他神经功能缺损的进展。该病例表明，对于出现脊髓病的慢性酒精中毒患者，应密切监测营养缺乏情况。
