FUNICULAR MYELOSIS

FUNICULAR MYELOSIS is a chronic dystrophic lesion of the lateral and posterior funiculi (funiculars) of the spinal cord, which usually develops in patients with achilic gastritis and pernicious anemia.

The main cause is a deficiency in the body of vitamin B12, which determines both the development of pernicious anemia (see Anemia) and the spinal cord injury. The vitamin B12, supplied with food, is not absorbed in the gastrointestinal tract due to the absence of the internal factor of the Castle, which normally is produced by the glands of the mucous membrane of the stomach. With achilic gastritis or after gastrectomy, normal utilization of vitamin B12 is disrupted and chronic deficiency occurs.

Clinically, the disease manifests as paresthesias in the feet, then the deep sensitivity disorders, sensory ataxia and weakness in the legs are added. Typical forms are characterized by a combination of sensory ataxia and paraplegia (atactic paraplegia). Paresis of the legs can be spastic, or lethargic. Tendon reflexes are initially elevated, but as the disease progresses, they decrease and disappear. Stop pathological reflexes are constantly detected. A symptom of Babinsky, etc. The combination of pyramidal symptoms with flaccid leg paresis is a characteristic feature of funicular myelosis. Sensitive and motor disorders are accompanied by violations of the function of the pelvic organs (delay or incontinence of urine and feces). Pain is not characteristic.

Treatment is carried out with vitamin B12 according to a certain scheme. Treatment, started several weeks after the appearance of spinal symptoms, usually leads to recovery. At belated treatment, only improvement or stabilization of the process is noted. The main regress of symptoms is observed in the first 3 to 6 months of treatment.