{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:45:04Z","timestamp":1788389104284,"version":"build-2803163510"},"reference-count":11,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,4]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>A 42-year-old man from rural India presented with asymmetric progressive paraparesis mimicking compressive dorsal myelopathy, followed by distal upper limb, truncal and neck-flexor weakness, further complicated by acute urinary retention. His sensory deficits were marked by loss of joint position sense (JPS) and graded loss of vibration sense, along with a definite sensory level. Deep tendon jerks were hypo-to-areflexic, plantar was bilaterally extensor. He had become less attentive and occasionally failed to keep track with conversations. A syndromic diagnosis of myeloradiculoneuropathy with cognitive impairments was made. Further tailored investigations revealed vitamin B<jats:sub>12<\/jats:sub> deficiency with positive anti-parietal cell antibody. Diagnosis of subacute combined cord degeneration (SACD) was confirmed. Neuro-imaging revealed intramedullary intensity changes only along lateral aspect of spinal cord instead of characteristic posterior involvement. Following parenteral vitamin B<jats:sub>12<\/jats:sub> supplementation, patient started showing improvement in motor power and subjective sensory symptoms. His bladder symptoms persisted initially, however recovered finally after 6 months.<\/jats:p>","DOI":"10.1136\/bcr-2020-239415","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T11:42:46Z","timestamp":1611574966000},"page":"e239415","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Myeloradiculoneuropathy due to vitamin B<sub>12<\/sub> deficiency: an unusual clinical and radiological presentation"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9075-2000","authenticated-orcid":false,"given":"Shambaditya","family":"Das","sequence":"first","affiliation":[{"name":"Neurology, Institute of Postgraduate Medical Education and Research, Bangur Institute of Neurosciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1733-3429","authenticated-orcid":false,"given":"Souvik","family":"Dubey","sequence":"additional","affiliation":[{"name":"Neurology, Institute of Postgraduate Medical Education and Research, Bangur Institute of Neurosciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alak","family":"Pandit","sequence":"additional","affiliation":[{"name":"Neurology, Institute of Postgraduate Medical Education and Research, Bangur Institute of Neurosciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biman Kanti","family":"Ray","sequence":"additional","affiliation":[{"name":"Neurology, Institute of Postgraduate Medical Education and Research, Bangur Institute of Neurosciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"2025082702311433000_14.1.e239415.1","first-page":"1","article-title":"Vitamin B12 deficiency","volume":"3","author":"Green","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"2025082702311433000_14.1.e239415.2","doi-asserted-by":"crossref","DOI":"10.4103\/ijem.IJEM_122_19","article-title":"Vitamin B12 deficiency is endemic in Indian population: a perspective from North India","volume":"23","author":"Singla","year":"2019","journal-title":"Indian J Endocrinol Metab"},{"key":"2025082702311433000_14.1.e239415.3","doi-asserted-by":"crossref","DOI":"10.1186\/s13104-015-1437-9","article-title":"B12 deficiency with neurological manifestations in the absence of anaemia","volume":"8","author":"Ralapanawa","year":"2015","journal-title":"BMC Res Notes"},{"key":"2025082702311433000_14.1.e239415.4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1159\/000505321","article-title":"A case of subacute combined degeneration of spinal cord diagnosed by vitamin B12 administration lowering methylmalonic acid","volume":"12","author":"Hara","year":"2020","journal-title":"Case Rep Neurol"},{"key":"2025082702311433000_14.1.e239415.5","doi-asserted-by":"crossref","first-page":"183","DOI":"10.4103\/0972-2327.182303","article-title":"Approach to a case of myeloneuropathy","volume":"19","author":"Garg","year":"2016","journal-title":"Ann Indian Acad Neurol"},{"key":"2025082702311433000_14.1.e239415.6","doi-asserted-by":"crossref","unstructured":"Nouri A , Patel K , Montejo J . 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