Copper deficiency can present with which of the following neurological findings?

Copper deficiency can present with which of the following neurological findings?

• A. Dysarthria
• B. Nystagmus
• C. Sensory ataxia
• D. Tremor

Answer: (C)

Copper deficiency often produces a myelopathy that resembles subacute combined degeneration, with damage to the dorsal columns and lateral spinothalamic/corticospinal tracts. The hallmark is loss of proprioception and vibration along with impaired position sense, leading to an unsteady, ataxic gait that is primarily sensory in nature. This sensory ataxia—where coordination problems arise from a failure to detect limb position—explains why gait instability improves only with visual input or after restitution of copper status. Dysarthria, nystagmus, or tremor can occur in other neurologic conditions or with broader CNS involvement, but they are not the classic or most specific manifestations of copper deficiency. The classic pattern is the sensory ataxia from posterior column dysfunction, often with accompanying numbness or tingling in the extremities.

Copper deficiency often produces a myelopathy that resembles subacute combined degeneration, with damage to the dorsal columns and lateral spinothalamic/corticospinal tracts. The hallmark is loss of proprioception and vibration along with impaired position sense, leading to an unsteady, ataxic gait that is primarily sensory in nature. This sensory ataxia—where coordination problems arise from a failure to detect limb position—explains why gait instability improves only with visual input or after restitution of copper status.

Dysarthria, nystagmus, or tremor can occur in other neurologic conditions or with broader CNS involvement, but they are not the classic or most specific manifestations of copper deficiency. The classic pattern is the sensory ataxia from posterior column dysfunction, often with accompanying numbness or tingling in the extremities.