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A 56-year-old woman presented with a four-month history of progressive cognitive decline, weakness, incoordination, and gait disturbance. She had a score of 12 of 28 on the Mini–Mental State Examination, moderate weakness, and severe ataxia; reflexes, vibratory sensation, and the sense of position were absent throughout her arms and legs. T2-weighted magnetic resonance imaging (MRI) of the brain demonstrated extensive areas of high-intensity signal in the periventricular white matter (Panel A, arrow). MRI of the spine showed a hyperintense signal along the posterior columns in all segments, including the lower portion of the cervical cord (Panel B, arrow). Laboratory . . . [Full Text of this Article] |
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