1. 48-year-old man with ascending sensory deficits Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology

2. 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

3. Imaging © 2014 American Academy of Neurology Gaechter et al

4. 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 Syndrome 1 – 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 pathomechanisms 2 Gaechter et al © 2014 American Academy of Neurology