Subacute Combined Degeneration of the Spinal Cord

      A 67-year-old man presented to the Emergency Department with a 3-month history of persistent numbness below the level of the neck and over all 4 limbs and the entire trunk. He had no known past medical or surgical history and was not on any chronic medications or supplementation. He was independent in his basic activities of daily living as well as instrumental activities of daily living, and used to work as a recycling assistant. He recently had to stop working due to his worsening medical condition and he did not adhere to a vegan diet. In addition to the numbness, he presented with an unsteady gait and had no history of falls or trauma to the head or neck region. Otherwise, he did not have any neck pain, muscle weakness, headache, dizziness, visual disturbances, bowel or bladder incontinence, diplopia, dysarthria, or dysphagia. He had no personal or family history of any psychiatric, neurological, or autoimmune conditions.


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