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48-year-old man with ascending sensory deficits
Teaching NeuroImagesNeurology
Resident and Fellow Section
© 2014 American Academy of Neurology
Vignette
• New-onset urinary retention• On clinical examination:
– generalized areflexia– mild lower extremity weakness– sensory ataxia– T2 sensory level– impaired smooth pursuit, but otherwise normal
cranial nerves
Gaechter et al© 2014 American Academy of Neurology
Imaging
© 2014 American Academy of Neurology Gaechter et al
Variant of Guillain-Barré syndrome with spinal cord involvement
• Combination of – CSF cytoalbuminologic dissociation on spinal tab and
demyelinating polyneuropathy fulfilling the electrodiagnostic criteria for Guillain-Barré Syndrome1
– Cervico-thoracic myelopathy as confirmed on MRI
• Conclusions– Acquired acute demyelination may rarely affect the
peripheral and central nervous system simultaneously (“GBS- transverse-myelitis overlap syndrome”)
– This is likely related to common auto-immune mediated pathomechanisms2
Gaechter et al© 2014 American Academy of Neurology