Metabolic and Toxic Myelopathies

Area of Science:

• Neurology
• Toxicology
• Metabolic Disorders

Background:

• Myelopathy can result from various metabolic and toxic insults.
• Increasing prevalence of vitamin B12 deficiency myelopathy due to aging populations.
• Emerging recognition of copper deficiency myelopathy, linked to bariatric surgery and zinc intake.

Purpose of the Study:

• To provide an updated review of metabolic and toxic myelopathies.
• To cover clinical presentations, diagnostic approaches, and management strategies.
• To highlight the importance of early recognition and intervention.

Main Methods:

• Literature review of recent findings on metabolic and toxic myelopathies.
• Synthesis of information on clinical manifestations and diagnostic evaluations.
• Discussion of therapeutic interventions and prognosis.

Main Results:

• Vitamin B12 and copper deficiencies present similar clinical pictures, necessitating prompt diagnosis.
• Substance abuse (heroin, nitrous oxide) and environmental toxins (lathyrism, konzo) are significant causes.
• Spinal cord injury can occur from decompression illness in divers and industrial workers.

Conclusions:

• Recognizing diverse metabolic and toxic causes of myelopathy is vital for neurologists.
• Timely diagnosis and rapid treatment initiation are essential for improving patient recovery outcomes.
• Awareness of less common causes like lathyrism and konzo is important due to global migration.