We report a 61-year-old man with slowly progressive gait disturbance and paresthesia in the lower extremities following a total gastrectomy for gastric cancer 23 years previously. The patient presented with hyperreflexia, peripheral sensory neuropathy, and cerebellar ataxia. Magnetic resonance imaging showed atrophy of the cerebellum, and electrophysiological findings suggested the presence of disorder in both sides of the pyramidal tract, dorsal column, peripheral nerves, and optic nerve. Laboratory findings revealed anemia, neutropenia, and a remarkably low serum copper level (10 microg/dl; normal: 68-128). His serum vitamin E was slightly low and his serum vitamin B12 was within the normal limits. After administering an oral copper supplement, his symptoms improved with normalization of the serum copper level. We need to pay attention to myeloneuropathy caused by copper deficiency if the patient has a past history of total gastrectomy
Keywords : adverse effects,Atrophy,complications,Copper,deficiency,Dermatitis,Seborrheic,etiology,Gait,Gastrectomy,Hair Diseases,history,Humans,Intracranial Arteriosclerosis,Lower Extremity,Magnetic Resonance Imaging,Male,Metabolism,Inborn Errors,Middle Aged,Optic Nerve Diseases,Paresthesia,Peripheral Nerves,Peripheral Nervous System Diseases,Postoperative Complications,Seizures,Spinal Cord Diseases,Stomach Neoplasms,surgery,Time Factors,, Neuropathy,Myelopathy,Cerebellar,Ataxia, synvisc uk
Date of Publication : 2011 Jun
Authors : Inaba M;Torii T;Shinoda K;Yamasaki R;Ohyagi Y;Kira J;
Organisation : Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyusyu University
Journal of Publication : Rinsho Shinkeigaku
Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21735733
The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery
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