Subacute combined degeneration of the spinal cord has come to involve a major problem that centers about the type of degeneration seen typically in pernicious anemia. More than sixty associated conditions or causes have been advanced for combined degeneration that often is said to be "just like that of pernicious anemia" (table 1). In some instances involvement of posterior and lateral columns, regardless of the absence of the usual status spongiosus or the presence of prominent fibrillar gliosis, fills the requirement of "like"; in others an occasional focus of perivascular demyelinization, regardless of its nature or topography, or degeneration of the posterior roots with secondary degeneration in the posterior column suffices; too much confidence may be placed in a typical or suggestive clinical picture of combined degeneration, or an unusual clinical picture may pass without comment. Criteria needed to rule out pernicious anemia or some kindred disturbance often are left
WOLTMAN HW, HECK FJ. FUNICULAR DEGENERATION OF THE SPINAL CORD WITHOUT PERNICIOUS ANEMIA: NEUROLOGIC ASPECTS OF SPRUE, NONTROPICAL SPRUE AND IDIOPATHIC STEATORRHEA. Arch Intern Med (Chic). 1937;60(2):272–300. doi:10.1001/archinte.1937.00180020096008
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