Syringomyelia associated with syphilitic spinal meningitis: real complication or possible association?

STUDY DESIGN: The study has been designed as a case report. OBJECTIVE: The objective of this study was to report a rare case of syringomyelia in a patient with syphilitic spinal meningitis. SETTING: The Neurology Department, University Hospital Mohamed VI Marrakesh, Morocco. CASE REPORT: A 40-year-old Moroccan male presented with the complaints of weakness of the lower extremities. Neurological examinations confirmed the motor dysfunction of the lower extremities and revealed a sensory loss to the T2-T4 dermatome. The magnetic resonance imaging (MRI) scan detected a hypointense signals on the T1 sequences and hyperintense signals on T2 in the cord extending from C7 to T4. The condition was diagnosed as dorsal syringmyelia. Blood and cerebrospinal fluid were positive for Venereal Disease Research Laboratory and Treponema pallidum hemagglutination tests. The patient was treated with intravenous penicillin therapy with a significant improvement in motor deficit. After 2 years, his neurological deficit was limited to a mild weakness of the distal right leg. CONCLUSION: A case of syphilitic spinal meningitis presenting with syringomyelia, and effectively treated with penicillin has been described.