Subacute combined degeneration (SCD)

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Subacute combined degeneration (SCD). Pernicious anaemia, Cobalamin C disease. Fully referenced neurology checklist.

Causes

  • Pernicious anaemia
  • Cobalamin C disease
  • Nitrous oxide inhalation and anaesthesia
  • Tripterygium glycoside: treatment for glomerulonephritis
  • Vegan diet
  • Crohn’s disease
  • Common variable immunodeficiency syndrome (CVID)
  • Gastric cancer
  • Gastric resection

Clinical features

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Associated features of B12 deficiency

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Magnetic resonance imaging (MRI)

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Differential diagnosis

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Treatment

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References

  1. Hemmer B, Glocker FX, Schumacher M, Deuschl G, Lucking CH. Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance findings. JNNP 1998; 65:822-827.
  2. Thomas PK. Subacute combined degeneration. JNNP 1998; 65:807.
  3. Smith SE, Kinney HC, Swoboda KJ, Levy HL. Subacute combined degeneration of the spinal cord in cblC disorder despite treatment with B12. Mol Genet Metab 2006; 88:138-145. 
  4. Keddie S, Adams A, Kelso ARC, et al. No laughing matter: subacute degeneration of the spinal cord due to nitrous oxide inhalation. J Neurol 2018; 265:1089-1095.
  5. Renard D, Dutray A, Remy A, Castelnovo G, Labauge P. Subacute combined degeneration of the spinal cord caused by nitrous oxide anaesthesia. Neurol Sci 2009; 30:75-76. 
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