THE CANADIAN JOuRNAL OF NEuROLOGICAL SCIENCES

Deficiency of Vitamin B12 can have many neurologic sequelae including periperhal neuropathy, visual disturbances, mood and memory changes and subacute combined degeneration (SCD) of the spinal cord1. Macrocytic anemia is also a common finding of B12 deficiency allowing the clinician to arrive at a diagnosis, however neurologic symptoms can be present even in the absence of hematologic changes. Subacute combined degeneration is a progressive myelopathic condition that is typified by a number of neurologic deficits including sensory abnormalities, proximal to distal paresthesias, weakness, ataxia and gait impairment1. In addition to exam findings, cervical lesions in the posterior spinal cord can be identified on magnetic resonance imaging (MRI)2. In this report we present a patient with a unique episodic dysosmia characterized by the smell of burned wood, loss of taste, mood disturbance, parasthesias and imbalance. Vitamin B12 therapy reversed or significantly improved all of these symptoms and led to reversal of the laboratory abnormalities and cervical MRI findings.