Diagnostics
During the physical examination, the following features of funicular myelosis are particularly noticeable: If the water in the spinal canal (liquor) is also examined, two thirds of the affected patients show an increase in protein. The measurement of nerve conduction velocity (electroneurography) shows a slowdown in about three-quarters of the patients, which is partly due to a polyneuropathy existing at the same time. If the blood is examined, a megalocytic hyperchromic anemia (certain form of anemia) can be detected in some cases, as well as a partial destruction of the red blood cells and a decrease in the white blood cells.
A reduction in the vitamin B12 concentration in the blood is also measured. The so-called Schilling test can be used to diagnose a disturbance in the absorption of vitamin B12 in the small intestine.
- Pale yellow skin
- Yellow coloration of eye whites (sclerae)
- Hunter glossitis (regression of the tongue mucosa) with red, burning tongue
- Sensitivity disorders in legs and feet
- Muscle weakness in legs and feet
- Gang insecurity
- Positive Romberg sign
- Pathologically altered reflexes
- Weakened or missing self-reflexes
- Greatly reduced vibration sensation
- Strongly reduced position sensitivity
- Delusions
- Symptoms of dementia
- Depressive moods
Imaging diagnostics in the form of magnetic resonance imaging (MRI) is not always necessary, but it can confirm the diagnosis.
Especially in the case of atypical symptoms that do not clearly fit a funicular myelosis, an MRI is often performed. MRI examination reveals damage primarily in the area of the posterior cords of the spinal cord and in the area around the ventricles (area of the subcortical, periventricular medullary bed). The posterior strand of the spinal cord can also be affected.
The affected structures are responsible in particular for aspects of the sense of touch and for the body’s perception in space (proprioception). The damage there explains the symptoms. The MRI image is taken using the so-called T2 weighting technique, in which cerebral fluid and swollen tissue are brightly displayed. Accordingly, bright spots can be seen in the above-mentioned areas of the spinal cord. The rest of the spinal cord appears dark.
