Syringomyelia coexisting with guillain-barre syndrome

Area of Science:

• Neurology
• Immunology
• Neurosurgery

Background:

• Guillain-Barre syndrome (GBS) is an acute autoimmune polyneuropathy targeting peripheral nerve myelin.
• Syringomyelia is a chronic myelopathy characterized by a spinal cord syrinx.
• Co-occurrence of GBS and syringomyelia is rare and can complicate diagnosis.

Purpose of the Study:

• To report a case of coexisting Guillain-Barre syndrome and symptomatic syringomyelia.
• To highlight diagnostic challenges posed by overlapping symptoms.
• To emphasize the importance of considering syringomyelia in GBS patients with atypical progression.

Main Methods:

• Clinical case presentation of a 67-year-old male.
• Neurological examination, including motor power and deep tendon reflexes.
• Nerve conduction studies and cerebrospinal fluid analysis for GBS diagnosis.
• Spinal magnetic resonance imaging (MRI) and somatosensory evoked potentials (SSEPs) for syringomyelia evaluation.

Main Results:

• The patient initially presented with GBS symptoms: ascending weakness and areflexia.
• Follow-up revealed new symptoms suggestive of spinal cord pathology: sensory changes, urinary dysfunction, and hyperreflexia.
• MRI confirmed a cervical syrinx, and SSEPs indicated sensory pathway defects, confirming syringomyelia.
• The patient was diagnosed with both GBS and syringomyelia.

Conclusions:

• Symptomatic syringomyelia can coexist with Guillain-Barre syndrome.
• The progressive muscle weakness and reduced reflexes in GBS can mask the early signs of syringomyelia.
• Prompt recognition and diagnostic workup are essential for managing patients with this rare dual diagnosis.