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J Pharmacol Exp Ther 187: 185-194, 1973

4) Loss of oligodendrocytes (demyelination) In the acute phase of SCI, death of oligodendrocytes is mediated by apoptosis, necrosis, and autophagy

Figure 1 shows the time course of drug concentration and associated rates of elimination and input for a constant rate input over 1 hour

These symptoms often occur before a B12 deficiency is clearly detectible in the blood, which is why the serum level for vitamin B12 is no longer considered a reliable marker (2, 3)