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

BMJ Case Rep. 2018 Sep 27:2018:bcr2018225750. doi: 10.1136/bcr-2018-225750.

Abstract

Syringomyelia is the development of a fluid-filled cavity or syrinx within the spinal cord that can cause loss of sensation and muscle spasticity. Guillain-Barre syndrome (GBS) is a postinfection autoimmune disease, classified as an acute polyneuropathy. This report describes the emergency admission of a 6-year-old girl presenting with sudden pallor and pain in both lower limbs. The patient's reflexes were normal, as were the results of her sonography, radiography and biochemical tests; however, spinal MRI revealed extensive compartmentalised syringomyelia extending from C2 to T3. A sensory and motor nerve conduction study revealed a demyelinating type motor polyneuropathy which, along with positive Mycoplasma pneumoniae test, was suggestive of GBS. Intravenous immunoglobulin infusion showed excellent results. In conclusion, we report a rare paediatric case of syringomyelia coexisting with GBS. It is important to bear in mind the possibility of other coexisting diseases even if MRI reveals definitive characteristics of another condition.

Keywords: congenital disorders; infection (neurology); neurology; paediatrics; peripheral nerve disease.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Female
  • Guillain-Barre Syndrome / complications*
  • Guillain-Barre Syndrome / diagnosis
  • Guillain-Barre Syndrome / drug therapy
  • Guillain-Barre Syndrome / microbiology
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Magnetic Resonance Imaging
  • Mycoplasma pneumoniae / isolation & purification
  • Pneumonia, Mycoplasma / complications*
  • Spinal Cord / diagnostic imaging
  • Syringomyelia / complications*
  • Syringomyelia / diagnostic imaging

Substances

  • Immunoglobulins, Intravenous