Funicular myelosis
Funicular myelosis is a degenerative spinal cord disease that is caused by a vitamin B12 deficiency and whose clinical picture is reminiscent of multiple sclerosis. However, if detected early, symptoms often disappear completely after vitamin B12 administration.
What is Funicular Myelosis?
Funicular myelosis (synonym: funicular spinal disease) is triggered by vitamin B12 deficiency. It is one of the so-called demyelination diseases. These are diseases in which the nerves degenerate.
A breakdown of the nerve fibers in the dorsal column and collateral column of the spinal cord is typical of funicular myelosis. The degeneration of the central nervous system leads to failures in sensory perception and motor function. Pernicious anemia , which is also caused by vitamin B12 deficiency, can occur parallel to or after funicular myelosis.
causes
The cause of funicular myelosis is a vitamin B12 deficiency, which can have various causes. Intrinsic factor, formed in the stomach, is a protein that is necessary for the absorption of vitamin B12 from food . If the intrinsic factor is missing, for example due to chronic inflammation of the gastric mucosa , this can lead to a vitamin B12 deficiency. Other absorption disorders, defects in the vitamin B12 metabolism or a greatly increased vitamin B12 consumption (e.g. in the case of fish tapeworm infestation) can also trigger funicular myelosis.Funicular myelosis is rarely diet-related because the body has a high storage capacity for vitamin B12. However, cases of funicular myelosis have been diagnosed in vegans, who often eat a diet that is almost vitamin B12-free. Also, certain medications can cause funicular myelosis. For example, funicular myelosis has been reported after administration of phenobarbital, methotrexate (when used in high doses as a cytostatic agent) and after anesthesia with nitrous oxide.
symptoms and course
Typical symptoms of funicular myelosis:
- tingling in the feet
In the case of funicular myelosis, various perceptual disorders occur as symptoms due to the breakdown of nerve fibers in the spinal cord. These often begin as tingling or numbness in the feet, and later in the hands and legs. As the funicular myelosis progresses, proprioception (perception of the position of one’s own body and the position of the body parts in relation to one another) can be impaired, resulting in a shaky, unsteady gait.
The perception of touch, pressure and vibration is often impaired. In the late stage, cramps and paralysis can occur. Stomach pain, diarrhea and other digestive tract problems are also typical symptoms. However, if vitamin B12 deficiency is detected in time, the prognosis is good and a complete resolution of the symptoms of funicular myelosis after vitamin B12 administration is possible.
Diagnose
A suspicion of funicular myelosis usually arises when a comprehensive neurological examination is carried out due to the symptoms mentioned above. In order to clearly diagnose funicular myelosis and to differentiate it from other diseases with a similar clinical picture (multiple sclerosis, neuroborreliosis ), the vitamin B12 level in the blood is determined.
The cause of the vitamin B12 deficiency is then examined. A gastroscopy shows whether there is inflammation of the gastric mucosa that leads to vitamin B12 deficiency. With the so-called Schilling test, the doctor examines whether the funicular myelosis was caused by an absorption disorder of vitamin B12.
treatment and therapy
Funicular myelosis is based on a vitamin B12 deficiency and can therefore be treated relatively easily by administering vitamin B12. Vitamin B12 can be injected into the muscle or given intravenously. Initially, daily injections are often necessary. As soon as the vitamin B12 stores in the body have been replenished, the frequency of vitamin B12 administration can be reduced.
One injection every 4 to 12 weeks is then often sufficient. If the cause of the funicular myelosis has been identified, it will also be treated if necessary. If, for example, there is inflammation of the gastric mucosa (gastritis), then the vitamin B12 intake can normalize again after treatment, so that no further vitamin B12 administration is necessary. If the neurological symptoms are accompanied by anemia , blood formation is supported by an additional supply of iron .If funicular myelosis is detected early, complete regeneration of the nerves is possible, and the symptoms then disappear completely. In severely advanced nerve degeneration, however, permanent, irreparable damage can remain. In any case, however, vitamin B12 administration prevents the symptoms of funicular myelosis from worsening.
prevention
People who fear that their intake of vitamin B12 is too low due to illness or their diet should think about preventing funicular myelosis . These include vegans (if they are not taking any supplements) and people with chronic gastritis or known deficiencies in vitamin B12 metabolism.
The doctor can then determine the vitamin B12 level in the blood. This makes it possible to state quickly and reliably whether there is a risk of funicular myelosis occurring or not.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.