Syringomyelia Coexisting With Guillain-Barre Syndrome

Abstract

Guillain-Barre syndrome (GBS) and syringomyelia are diseases of different entities. GBS is an acute post-infectious autoimmune disease which is mediated by autoantibodies against the myelin of peripheral nerves. Syringomyelia is a chronic disease characterized by a cavity extending longitudinally inside the spinal cord. A 67-year-old man is being hospitalized due to severe numbness and ascending weakness in all limbs. On neurological examination, the motor power of all limbs are decreased and show absence of deep tendon reflexes (DTRs). The patient is being diagnosed with GBS on the basis of the acute clinical course, nerve conduction studies of segmental demyelinating polyneuropathy, and a finding of albuminocytologic dissociation in the cerebrospinal fluid. The patient is presented with a new set of symptoms thereafter, which composes of sensory changes in the upper extremities, the urinary dysfunction including frequency and residual urine, spastic bilateral lower extremities, and increased reflexes of the knee and the biceps at follow-up examinations. The spinal magnetic resonance imaging in the sagittal section revealed a syrinx cavity between the fifth cervical and the first thoracic vertebral segment in the cord. The somatosensory evoked potential show sensory pathway defects between both the brachial plexus and the brain stem. Thus, this patient is being diagnosed with both GBS and syringomyelia. We report a case of symptomatic syringomyelia coexisting with GBS. Since the GBS is presented with a progressive muscle weakness and reduced DTRs, the muscle weakness and stiffness in the extremities suggests a concurrent syringomyelia might be easily overlooked.

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“…Nowadays, given the availability of MRI, we see more and more patients in whom an image of a more or less extensive intramedullary cavity is discovered either incidentally or during various clinical signs, signs and electrophysiological evoking neuropathy including GBS. The association of Guillain Barré syndrome and syringomyelia is exceptional [1]. In the literature, the coexistence of Guillain barré syndrome secondary to a mycoplasma infection and pre-existing syringomyelia has been described in a similar observation in a 6-year-old girl [3].…”

Thoracic Endodermal Sinus Tumor with Root Compression Mimicking Guillain–Barre Syndrome in Clinical Presentation, CSF Studies, and EMG/NCV Findings

“…6 An adult patient with clinical, CSF, and electrophysiological evidence of GBS developed a different clinical picture 1 month later attributed to a syrinx; the two were not believed to be causally related. 7 Spinal hydatid cysts have been reported in an adult patient with clinical GBS but no electrophysiological or CSF studies were performed. 8 Germ cell tumors (GCT) arise from primordial germ cells and account for approximately 3% of cancers in children younger than 15 years of age.…”

Comorbid presentation of syringomyelia and Guillain-Barre syndrome, attributed to mycoplasma, in a 6-year-old female patient

“…To our best knowledge, the comanifestation of syringomyelia and GBS has been reported only once in the literature10 and in an adult patient. Herein, we present the first case of concurrent appearance of syringomyelia and GBS in a 6-year-old patient, the manifestations of this combination and the successful resolution with timely medical intervention.…”