Copper Deficiency Myelopathy Can Also Involve the Brain Stem

G Kumar,S Lucchese,U Dhand,M.K Goyal

doi:10.3174/ajnr.a2261

Abstract

Copper deficiency is rare but can result from gastrointestinal surgery, excess zinc in the diet, parenteral nutrition, and malabsorption syndromes.[1][1] Copper deficiency gives rise to a sensory ataxic myelopathy, symmetrically involving the pyramidal tracts and dorsal columns in the spinal cord,[2

Highlights

A 47-year-old man with a history of denture cream use insidiously developed bilateral painless vision loss, paresthesias, and quadriparesis over 4 weeks
Mild normocytic anemia was present; vitamin B12 and serum zinc were within normal levels
Dietary copper deficiency is rare but results from causes such as gastrointestinal surgery, zinc excess, malabsorption syndromes, and parenteral nutrition.[1]. It is associated with symmetric involvement of the pyramidal tract and posterior columns, resulting in a clinical and radiologic picture indistinguishable from SCD2; rarely peripheral neuropathy and optic neuritis have been described.[3]

Summary

Introduction

A 47-year-old man with a history of denture cream use insidiously developed bilateral painless vision loss, paresthesias, and quadriparesis over 4 weeks. Neurologic examination revealed left afferent pupillary defect and the presence of optic neuritis.

Results

Conclusion