Mielopatía cervical por déficit de cobre secundario a sobrecarga de zinc dental. A propósito de un caso / Cervical myelopathy due to copper deficiency secondary to dental zinc overload: A case report

Se presenta el caso de un varón de 68años con un cuadro progresivo de hipoestesia braquial y crural con ataxia de la marcha, sugiriendo una mielopatía subaguda de cordones posteriores, demostrada en RM. Tras analítica sanguínea se diagnostica de déficit de cobre tras intoxicación por zinc, secundario al uso de un pegamento para dentaduras postizas que contenía zinc. Se inició tratamiento con cobre, retirándose el pegamento dental. Se inició tratamiento rehabilitador con fisioterapia, hidroterapia y terapia ocupacional. Se consiguió una mejoría funcional, pasando de una lesión medular ASIAD nivel C4 a otra ASIAD nivel C7. Deberían estudiarse los niveles de cobre en todas aquellas mielopatías no compresivas, de aparición subaguda, si existe una clara afectación de los cordones posteriores. El déficit de cobre en análisis establecería el diagnóstico. El tratamiento rehabilitador, el aporte de cobre suplementario y la retirada del zinc es fundamental para la prevención de daño neurológico irreversible.(AU)

We present the case of a 68-year-old man with progressive brachial and crural hypoaesthesia with gait ataxia suggesting subacute myelopathy of the posterior cords, demonstrated by MRI. After blood tests, a diagnosis of copper deficiency was made following zinc intoxication, secondary to the use of denture glue containing zinc. Treatment was started with copper and the dental glue was removed. Rehabilitation treatment was started with physiotherapy, hydrotherapy and occupational therapy. Functional improvement was achieved, going from an ASIAD level C4 to an ASIAD level C7 spinal cord injury. Copper levels should be studied in all non-compressive myelopathies of subacute onset if there is clear involvement of the posterior cords. Copper deficiency in analysis would establish the diagnosis. Rehabilitative treatment, supplementary copper supplementation and zinc withdrawal are essential to prevent irreversible neurological damage.(AU)

[Cervical myelopathy due to copper deficiency secondary to dental zinc overload: A case report]. / Mielopatía cervical por déficit de cobre secundario a sobrecarga de zinc dental. A propósito de un caso.

We present the case of a 68-year-old man with progressive brachial and crural hypoaesthesia with gait ataxia suggesting subacute myelopathy of the posterior cords, demonstrated by MRI. After blood tests, a diagnosis of copper deficiency was made following zinc intoxication, secondary to the use of denture glue containing zinc. Treatment was started with copper and the dental glue was removed. Rehabilitation treatment was started with physiotherapy, hydrotherapy and occupational therapy. Functional improvement was achieved, going from an ASIAD level C4 to an ASIAD level C7 spinal cord injury. Copper levels should be studied in all non-compressive myelopathies of subacute onset if there is clear involvement of the posterior cords. Copper deficiency in analysis would establish the diagnosis. Rehabilitative treatment, supplementary copper supplementation and zinc withdrawal are essential to prevent irreversible neurological damage.