The anemia can also lead to subtle demyelinative neurological symptoms (subacute combined degeneration of spinal cord).

Vitamin B12 deficiency (cyanocobalamin) leads to megaloblastic anemia and subacute combined degeneration of spinal cord.

The pathophysiologic state of the spinal cord is called subacute combined degeneration of spinal cord.

The presence of peripheral sensory-motor symptoms or subacute combined degeneration of spinal cord strongly suggests the presence of a B deficiency instead of folate deficiency.

Subacute combined degeneration of spinal cord secondary to pernicious anaemia can lead to slight peripheral nerve damage to severe damage to the central nervous system, affecting speech, balance and cognitive awareness.

Neurological symptoms: Sensory or motor deficiencies (absent reflexes, diminished vibration or soft touch sensation), subacute combined degeneration of spinal cord, or even symptoms of dementia and or other psychiatric symptoms may be present.

A complication of severe chronic PA is subacute combined degeneration of spinal cord, which leads to distal sensory loss (posterior column), absent ankle reflex, increased knee reflex response, and extensor plantar response.

Subacute combined degeneration of spinal cord, also known as Lichtheim's disease, refers to degeneration of the posterior and lateral columns of the spinal cord as a result of vitamin B deficiency (most common) or vitamin E deficiency.