Copper deficiency causes a similar picture like vitamin B12 deficiency

We report the case of a 57-year old female patient who presented with a gait disorder and sensory disturbances a few years after gastrectomy. In the neurological examination, clinical findings were similar to those observed in vitamin B-12 deficiency. T2-weighted images in the MRI of the spine showed an increased T2-signal involving the dorsal cervical cord. After exclusion of a vitamin B-12 deficiency, a copper deficiency was diagnosed causing the clinical symptoms and MRI findings. Copper deficiency as a cause of myelopathy is underrecognized. The clinical picture bears striking similarities to vitamin B12 deficiency and should be considered as a differential diagnosis.