Combined sclerosis or postero-lateral sclerosis of the spinal cord occurring in certain conditions, more especially pernicious or grave secondary anemia, has been recognized for many years; it was not, however, until 1913 that the characteristic loss of sensation was pointed out by Dejerine.1 That eminent French neurologist showed that the affection of the posterior columns begins medially and spreads outward; as a result the fibers which are first involved are the long conduction fibers which ascend uncrossed in the columns of Goll and Burdach. This gives a loss of certain forms of deep sensibility, that is, of the sense of position and the sense of vibration; all other forms of sensation remain intact until the disease has produced widespread changes in the cord, changes which amount practically to a transverse myelitis. Patients with the disease almost invariably have subjective sensory disturbances in the form of paresthesias of the feet,
WILSON G. THE RESEMBLANCE OF THE SENSORY SYMPTOMS OF POST-DIPHTHERITIC ATAXIA TO THOSE SEEN IN THE CORD CHANGES OF SEVERE ANEMIA. Arch NeurPsych. 1919;2(2):201–206. doi:10.1001/archneurpsyc.1919.02180080055006
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