Due to her easy fatigability, a 54-year-old woman is assessed at the clinic. There has been no weight gain or cold intolerance in the patient, and there is no history of thyroid disorders. Her medical history suggests that she should have a gastrectomy due to a nonhealing gastric ulcer. A glossy tongue and light palmar wrinkles are visible on physical examination. When her eyes are closed, her walking becomes unsteady, and her vibration awareness is significantly reduced in her lower limbs. There is modest symmetrical weakness in the proximal lower extremities muscles. The hemoglobin level in the blood is 7.2 g/dL, and the white blood cell count is 3,600/mm³. Stool tests for occult blood have always come out negative. Which of the following spinal cord lesions is this patient most likely to have?

Question

Quizplus · Accepted Answer

Eductional Objective: Subacute simultaneous degeneration of the dorsal columns (loss of position and vibration sensation, positive Romberg sign) and lateral corticospinal pathways is commonly associated with vitamin B₁₂ deficiency (spastic paresis).

Due to Her Easy Fatigability, a 54-Year-Old Woman Is Assessed