SACD of the cord is a classic disease, affecting approximately 1 out of 10,000 people, it was a frequent complication of pernicious anaemia before effective treatment with raw liver or vitamin B12 became available. In recent years, it has become a rare condition owing to earlier recognition and treatment of pernicious anaemia. Vitamin B12 is abundant in meat, fish and most animal by-products, with vegetables being devoid of this vitamin (Patten, 1996). Accordingly, strict vegetarians have long been known to be at risk of vitamin B12 deficiency, which develops insidiously over many years. As well, it is now clear that a significant number of the elderly and HIV positive individuals are also at increased risk of deficiency. Any individua

Adams, RD, Victor, M, and Ropper, AH. (1997) Principles of Neurology. 6th edn. McGraw Hill. New York. Pp. 1151-1155.

Walton, L. (1989) Essentials of Neurology. 6th edn. Churchill Livingstone. London.p.314.

Even with a severe depletion of vitamin B12, an "average of 5 years" is needed to deplete the liver storage, thus strict vegetarians may not appear to be at a short-term risk. However, combined with certain factors such as: being female, menstruating, pregnant, and an insidious malabsorption syndrome - the onset of "at least 5 years" could be very misleading and the detrimental affects could be much less than five years. Thus, vegans take heed, of a supposed rare disease of a specific vitamin malnutrition, which might be more common than previously aforementioned.

MRI studies done by Locatelli, Laureno , Ballard and Mark (1999), show that after vitamin B12 replacement therapy MRI abnormalities typically improve, however, clinical signs may persist despite resolution of imaging abnormalities because symptoms usually precede the imaging abnormality. They concluded that spinal cord MRI may not be a highly sensitive, early test for subacute combined degeneration.

About 90% of the total body vitamin B12 (1-10mg) is stored in the liver. Thus, even with a severe depletion of B12, an average of 5 years is needed to deplete the body store (Yen, 2000).

Lindsay, KW and Bone, I. (1997) Neurology and Neurosurgery Illustrated. 3rd edn. Churchill Livingstone. New York. pp.523-524.

Some common words found in the essay are:
Vitamin B12, Investigation Current, Victor Ropper, Lindsay Bone, Pathology Pathophysiology, Deuschl Lucking, Cord SACD, B12 Patten, Physiology Dietary, Clinical Features, vitamin b12, spinal cord, b12 deficiency, vitamin b12 deficiency, patten 1996, pernicious anaemia, sacd cord, white matter, combined degeneration, intrinsic factor, yen 2000, vitamin b12 therapy, lindsay bone 1997, 1996 vitamin b12, cord classic disease,
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Approximate Pages = 8 (250 words per page double spaced)