[ Sclérose combinée de la moelle diagnostiquée au cours d'une grossesse: à propos d'un cas ]
Volume 12, Issue 4, September 2015, Pages 899–902
Jihad Drissi1, Farid Kassidi2, Jaouad Kouach3, Driss Rahali Moussaoui4, and Mohammed Dehayni5
1 Service de Gynécologie-Obstétrique, Hôpital militaire d'Instruction Mohammed V, Rabat, Morocco
2 Department of Gynecology-Obstetric, Military Training Hospital Med V, Rabat, Morocco
3 Faculté de Médecine et de Pharmacie, Université Mohamed V, Rabat, Morocco
4 Department of Gynecology-Obstetric, Military Training Hospital Med V, Rabat, Morocco
5 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2015 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: The combined degeneration of the cord is a rare cause of myelopathy, it is linked to a deficiency in vitamin BI2 which is the most common cause pernicious anemia. Rapid diagnosis is necessary because the recovery is more complete than replacement therapy with vitamin B12 is administered early. Pregnancy by increasing needs of the mother's body can be a vitamin deficiency. However, we have little data in the literature that describe the impact of this disease on the course of pregnancy.
Observation: We report the case of a 24-year-old primigravida in the third trimester of pregnancy presented a radiculo-cordonal syndrome later in connection with a hypovitaminosis B12. The course of pregnancy was unremarkable, with a marked improvement in his neurological symptomatology in vitamin supplementation.
Discussion and conclusion: combined degeneration of the cord is the main secondary to neurological hypovitaminosis B12. MRI can guide the diagnosis, favorable after adequate vitamin supplementation is a therapeutic test to retain the diagnosis. There is no particular impact of the disease on pregnancy or pregnancy on the disease. However, some cases of IUGR, preeclampsia and pseudo Hellp syndrome were described. In terms of obstetrical prognosis is marked by an expansion of instrumental delivery instructions and those depending on the severity of neurological involvement. Epidural and spinal anesthesia should be avoided. General anesthesia should not use nitrous oxide.
Author Keywords: combined degeneration of spinal cord, vitamin B12, pregnancy-pernicious anemia.
Volume 12, Issue 4, September 2015, Pages 899–902
Jihad Drissi1, Farid Kassidi2, Jaouad Kouach3, Driss Rahali Moussaoui4, and Mohammed Dehayni5
1 Service de Gynécologie-Obstétrique, Hôpital militaire d'Instruction Mohammed V, Rabat, Morocco
2 Department of Gynecology-Obstetric, Military Training Hospital Med V, Rabat, Morocco
3 Faculté de Médecine et de Pharmacie, Université Mohamed V, Rabat, Morocco
4 Department of Gynecology-Obstetric, Military Training Hospital Med V, Rabat, Morocco
5 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2015 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Introduction: The combined degeneration of the cord is a rare cause of myelopathy, it is linked to a deficiency in vitamin BI2 which is the most common cause pernicious anemia. Rapid diagnosis is necessary because the recovery is more complete than replacement therapy with vitamin B12 is administered early. Pregnancy by increasing needs of the mother's body can be a vitamin deficiency. However, we have little data in the literature that describe the impact of this disease on the course of pregnancy.
Observation: We report the case of a 24-year-old primigravida in the third trimester of pregnancy presented a radiculo-cordonal syndrome later in connection with a hypovitaminosis B12. The course of pregnancy was unremarkable, with a marked improvement in his neurological symptomatology in vitamin supplementation.
Discussion and conclusion: combined degeneration of the cord is the main secondary to neurological hypovitaminosis B12. MRI can guide the diagnosis, favorable after adequate vitamin supplementation is a therapeutic test to retain the diagnosis. There is no particular impact of the disease on pregnancy or pregnancy on the disease. However, some cases of IUGR, preeclampsia and pseudo Hellp syndrome were described. In terms of obstetrical prognosis is marked by an expansion of instrumental delivery instructions and those depending on the severity of neurological involvement. Epidural and spinal anesthesia should be avoided. General anesthesia should not use nitrous oxide.
Author Keywords: combined degeneration of spinal cord, vitamin B12, pregnancy-pernicious anemia.
Abstract: (french)
Introduction : la sclérose combinée de la moelle est une cause rare de myélopathie, elle est liée à une carence en vitamine BI2 dont la cause la plus fréquente est l'anémie de Biermer. Un diagnostic rapide est nécessaire puisque la récupération est d'autant plus complète que le traitement substitutif par la vitamine B 12 est administré précocement . La grossesse, par augmentation des besoins de l'organisme maternel, peut révéler un déficit vitaminique. Cependant, nous disposons de peu de données de la littérature qui décrivent le retentissement de cette maladie sur le déroulement de la grossesse.
Observation : nous rapportons le cas d'une primigeste de 24 ans qui au troisième trimestre de sa grossesse a présenté un syndrôme radiculo-cordonal postérieur en rapport avec une hypovitaminose B12. Le déroulement de la grossesse était sans particularités, avec une nette amélioration de sa symptômatologie neurologique sous supplémentation vitaminiques.
Discussion et conclusion : la sclérose combinée de la moelle est la principale atteinte neurologique secondaire à l'hypovitaminose B12. L'IRM permet d'orienter le diagnostic, l'évolution favorable après supplémentation vitaminique adéquate constitue un test thérapeutique qui permet de retenir le diagnostic. Il n'y a pas de retentissement particulier de la maladie sur la grossesse ni de la grossesse sur la maladie. Cependant, quelques cas de RCIU, prééclampsie et pseudo- Hellp syndrôme ont été décrit. Pour ce qui est du pronostic obstétrical il est marqué par un élargissement des indications d'extraction instrumentale et ceux en fonction de la sévérité de l'atteinte neurologique. Péridurale et rachi-anesthésie sont à proscrire. Quant à l'anesthésie générale elle ne devra nullement faire appel au protoxyde d'azote.
Author Keywords: sclérose combinée de la moelle, vitamine B12, grossesse, anémie de Biermer.
How to Cite this Article
Jihad Drissi, Farid Kassidi, Jaouad Kouach, Driss Rahali Moussaoui, and Mohammed Dehayni, “Combined degeneration of the spinal cord diagnosed during pregnancy: report of a case,” International Journal of Innovation and Applied Studies, vol. 12, no. 4, pp. 899–902, September 2015.
