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Neuroimaging (MRI of the spinal cord) may occasionally be warranted to exclude other pathology or to demonstrate the characteristic changes of subacute combined degeneration, though this is not routinely required for diagnosis

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64590: Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver

Perhaps the most devastating impact of B12 pathway dysfunction in chronic illness occurs within the central nervous system

Relationship of homocysteine folic acid and vitamin B12 with depression in a middle aged community sample