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