Subacute Combined Degeneration of the Spinal Cord Caused by an Impairment in the Functional Vitamin B12 Metabolic Pathway.

Subacute combined degeneration (SCD) of the spinal cord is a neurological disorder marked by degeneration in the dorsal and lateral columns, commonly linked to vitamin B12 deficiency. This report presents a case of SCD caused by a functional vitamin B12 deficiency. Although the patient displayed symptoms such as ataxia, sensory deficits, and motor impairment, initial lab tests showed normal serum vitamin B12 levels, complicating the diagnostic process. A comprehensive assessment identified poor nutrition as the root cause affecting the body's vitamin B12 metabolism. This case highlights the importance of considering SCD in patients with neurological symptoms, even when serum B12 levels appear normal. The report calls for greater awareness and thorough evaluation of vitamin B12 metabolic pathways in patients with unexplained neurological symptoms, emphasizing the need for clinicians to look beyond standard serum levels when assessing potential deficiencies.