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A B-wildering Case of Paraplegia: Cobalamin Deficiency

Published:September 30, 2013DOI:https://doi.org/10.1016/j.amjmed.2013.08.005
      An uninsured patient delayed adequate medical evaluation until he suffered permanent damage from an easily-treated condition. The 36-year-old Caucasian man presented with spastic paraplegia, decreased lower-extremity sensation, and sphincter incontinence. He explained that his illness started about 4 years earlier with back pain and lower-extremity paresthesia. His primary care physician recommended spine imaging, which was never performed due to lack of health insurance. Records from this past visit were unavailable.
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