clinical picture of copper deficiency myelopathy

Kumar N et al. Neurology 63:33-39, 2004

The clinical information on 13 patients was reviewed. All had sensory ataxia due to dorsal column dysfunction and lower limb spasticity. All had polyneuropathy. 7/11 had high or high normal zinc levels. 3 patients had dorsal column signal change on MRI. Some had low ceruloplasmin without Wilson's disease on further testing. Most patients did not have an etiology that was clearly established. Copper supplements prevented further deterioration, but resulted in variable amounts of improvement neurologically. The picture is strikingly similar to B12 deficiency.

Hedara et al. Arch Neurol 2003; 1303-1306 Postulates this is due to zinc overload and notes many such patients have high zinc levels, although he is not able to determine why. They also are pancytopenic.