PDF(Pubmed)
Abstract：
Subacute combined degeneration (SCD) from vitamin B12 deficiency and spinal stenosis from degenerative changes may present similarly with weakness, sensory disturbances, and ataxia but require different treatments. This case report describes a 74-year-old male with suspected SCD who was discharged to an inpatient rehabilitation facility (IRF), did not improve with B12 supplementation, and later developed signs of myelopathy and diffuse joint pain. He ultimately was found to have severe cervical stenosis and pseudogout that were treated with a laminectomy and colchicine, respectively. Following surgical intervention, he returned to the IRF, where he had considerable functional improvement and was safely discharged home. This report shows the importance of recognizing the two conditions, their overlap, and the contrast between Occam\'s razor and Hickam\'s dictum.
摘要：
维生素B12缺乏引起的亚急性联合变性（SCD）和退行性变化引起的椎管狭窄可能与虚弱相似。感觉障碍,和共济失调，但需要不同的治疗方法。该病例报告描述了一名74岁的男性，怀疑患有SCD，他已出院到住院康复机构（IRF）。补充B12没有改善，后来出现脊髓病和弥漫性关节痛。他最终被发现患有严重的宫颈狭窄和假性痛风，接受了椎板切除术和秋水仙碱治疗，分别。手术干预后，他回到了IRF,在那里，他有相当大的功能改善，并安全出院回家。这份报告显示了认识到这两个条件的重要性,它们的重叠，以及奥卡姆的剃刀和希卡姆的格言之间的对比。
