A 52-year-old man presents with progressive lower extremity weakness, spasticity, and hyperreflexia over 3 months. Vital signs: BP 138/82, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room air. MRI of the cervical and thoracic spine demonstrates longitudinal T2 hyperintensity extending from C2 to T6. Brain MRI is normal. Cerebrospinal fluid analysis reveals mild pleocytosis (12 WBC/μL) without oligoclonal bands. Which diagnosis best explains these findings?
- A)Spinal cord compression
- B)Multiple sclerosis
- C)Primary progressive MS
- D)Subacute combined degeneration from B12 deficiencyGABARITO
- E)Neuromyelitis optica spectrum disorder
Explicação
Subacute combined degeneration from B12 deficiency affects dorsal columns and corticospinal tracts, presenting with progressive spasticity, hyperreflexia, and posterior column signs. MRI shows longitudinal T2 signal change in cord. The normal brain MRI and abs... Ver explicação completa e trilha adaptativa →