Pathology

Spinal cord demyelination with eventual axon loss - affects: posterior columns and lateral columns (corticospinal and spinocerebellar tracts). Corticospinal degeneration is most evident in the lower cord, posterior column degeneration in the upper cord. Peripheral nerve large myelinated fibre degeneration also occurs.

B12 deficiency resulting in neurological damage is usually associated with a megaloblastic anaemia, though a normal peripheral blood film may be found.

Vitamin B12 deficiency results in the formation and accumulation of abnormal fatty acids with defective choline and phospholipids within the nervous system.

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