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Spinal tract degeneration confined to the bilateral posterior columns in malnutrition: Report of an autopsy case
Author(s) -
FUKUTANI YUKEN,
KATSUKAWA KAZUHIKO,
ISHIZAKI KEIKO,
TAKESHIMA TOSHIO,
KOBAYASHI KATSUJI,
YAMAGUCHI NARIYOSHI,
NAKAMURA ICHIRO,
WATANABE KISHICHIRO
Publication year - 1995
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/j.1440-1819.1995.tb01862.x
Subject(s) - autopsy , hypoproteinemia , posterior column , spinal cord , medicine , corticospinal tract , degeneration (medical) , pathology , anatomy , surgery , magnetic resonance imaging , radiology , psychiatry , acetabulum , diffusion mri
An autopsy case of malnutrition with spinal tract degeneration confined to the bilateral posterior columns is reported. The patient had schizophrenia in adolescence, and suffered from aplastic anemia in late middle age. Subsequently, he took little food due to delusions for 18 months until his death. He had malnutrition resulting in severe hypoproteinemia. He developed gait disturbance, loss of deep tendon reflexes and paresthesia of limbs. Neuropathological examination disclosed tract degeneration confined to the bilateral spinal posterior columns, in addition to the findings of aplastic anemia and hypoxic encephalopathy in the cerebrum. The myelin and axons were severely affected throughout the spinal cord; status spongiosus with many fatty‐laden macrophages was seen in these lesions. Neurons in the posterior column nuclei were intact, while the dorsal roots and their ganglia were moderately affected. The unusual distribution and extension of the degeneration of the bilateral posterior columns in the poor nutritional state is discussed.