Wk 1, Case 10 - Review

Report:

Examination:
Total spine MRI without and with contrast.

Indication: Progressive lower extremity weakness over the course of 1 or 2 weeks and diminished/absent lower extremity reflexes. Recent history of outdoor camping.

Technique: Multiplanar MR imaging of the total spine was
performed without and with the intravenous administration of gadolinium
contrast. Acquired sequences through the spine included sagittal T1, T2, axial T2, post contrast sagittal and axial T1.


Total spine:
There is diffuse pial enhancement involving the ventral and dorsal spinal nerve roots. No definite intramedullary cord signal abnormality or enhancement is present. There is no restricted diffusion within the cord.

There is anatomic alignment and position of the vertebral bodies and posterior elements of the cervical, thoracic, and lumbosacral spine. Vertebral body heights are preserved. Bone marrow signal is normal at all visualized levels. There is subtle loss of intervertebral disc height and signal at the level of C5-C6. Annular contours are normal. There is no canal stenosis nor cord compression. No neural foraminal narrowing within the cervical, thoracic, nor lumbosacral spine.

Limited visualization of the intrathoracic structures reveals an aberrant right subclavian artery. Limited visualization of the retroperitoneal structures reveals no abnormality.

IMPRESSION:
Extensive pial enhancement of the dorsal and ventral spinal nerve roots, suggestive of Guillain-Barré syndrome. Other infectious or inflammatory polyneuropathies may have a similar presentation and should also be considered within the differential diagnosis.