{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:06:17Z","timestamp":1753891577814,"version":"3.41.2"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> Inflammatory polyradiculomyelitis belongs to a rare group of immune-mediated diseases affecting both the central and peripheral nervous system. We aimed to describe an unusual presentation of acute polyradiculomyelitis with marked spinal cord lesions restricted to the gray matter.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Thorough examination of two case reports including clinical, MRI, serologic, electrophysiologic and CSF examinations as well as short-term follow-up.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> We present two adult patients with acute polyradiculomyelitis and unusual spinal cord lesions restricted to the gray matter on MRI. The clinical presentation, serologic, electrophysiologic and CSF features of the two patients varied, whereas both patients demonstrated severe, asymmetrical, predominantly distal, motor deficits of the lower extremities as well as bladder and bowel dysfunction. Both patients only partially responded to anti-inflammatory treatment. Severe motor impairment and bladder dysfunction persisted even months after symptom onset.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> To our best of knowledge, these are the first reports of acute polyradiculomyelitis with distinct involvement of the lower thoracic spinal cord gray matter. Currently, it remains unclear whether gray matter lesions reflect a separate pathophysiologic mechanism or an exceedingly rare presentation of spinal cord involvement in acute polyradiculomyelitis.<\/jats:p>","DOI":"10.3389\/fneur.2021.721669","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T06:55:27Z","timestamp":1629356127000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute Polyradiculomyelitis With Spinal Cord Gray Matter Lesions: A Report of Two Cases"],"prefix":"10.3389","volume":"12","author":[{"given":"Charidimos","family":"Tsagkas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Janina","family":"Wendebourg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Mehling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Lorscheider","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Lyrer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard Friedrich","family":"D\u00e9card","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1111\/jns5.12053","article-title":"Chronic inflammatory demyelinating polyradiculoneuropathy and variants: where we are and where we should go","volume":"19","author":"Nobile-Orazio","year":"2014","journal-title":"J Peripher Nerv Syst JPNS."},{"key":"B2","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1212\/WNL.56.6.758","article-title":"Preceding infections, immune factors, and outcome in Guillain-Barr\u00e9 syndrome","volume":"56","author":"Hadden","year":"2001","journal-title":"Neurology."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cnp.2019.11.003","article-title":"Very early Guillain-Barr\u00e9 syndrome: a clinical-electrophysiological and ultrasonographic study","volume":"5","author":"Berciano","year":"2020","journal-title":"Clin Neurophysiol Pract."},{"key":"B4","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1148\/radiology.208.1.9646804","article-title":"Guillain-Barr\u00e9 syndrome: MR imaging findings of the spine in eight patients","volume":"208","author":"Byun","year":"1998","journal-title":"Radiology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"25","DOI":"10.3941\/jrcr.v3i3.153","article-title":"Spinal MRI findings of Guillain-Barr\u00e9 syndrome","volume":"3","author":"Alkan","year":"2009","journal-title":"J Radiol Case Rep."},{"key":"B6","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1007\/s002470050059","article-title":"MR imaging in Guillain-Barr\u00e9 syndrome","volume":"27","author":"Iwata","year":"1997","journal-title":"Pediatr Radiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.clineuro.2019.04.014","article-title":"Clinical features and prognosis of patients with Guillain-Barr\u00e9 and acute transverse myelitis overlap syndrome","volume":"181","author":"Guo","year":"2019","journal-title":"Clin Neurol Neurosurg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"bcr2018225333","DOI":"10.1136\/bcr-2018-225333","article-title":"Primary Epstein-Barr virus infection in immunocompetent patients with acute transverse myelitis and a combination of polyradiculitis and anterior horn syndrome as neurological manifestations","volume":"2018","author":"Poorthuis","year":"2018","journal-title":"BMJ Case Rep."},{"key":"B9","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1111\/ped.12126","article-title":"Transverse myelitis and acute motor sensory axonal neuropathy due to legionella pneumophila: a case report","volume":"55","author":"Canpolat","year":"2013","journal-title":"Pediatr Int Off J Jpn Pediatr Soc."},{"key":"B10","doi-asserted-by":"publisher","first-page":"217","DOI":"10.3171\/jns.1988.68.2.0217","article-title":"Myelopathic cervical spondylotic lesions demonstrated by magnetic resonance imaging","volume":"68","author":"Al-Mefty","year":"1988","journal-title":"J Neurosurg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1001\/archneur.63.8.1113","article-title":"Spinal cord ischemia: clinical and imaging patterns, pathogenesis, and outcomes in 27 patients","volume":"63","author":"Novy","year":"2006","journal-title":"Arch Neurol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1080\/10790268.2018.1507804","article-title":"Myelopathy in west Nile virus encephalitis: report of a case and review of literature","volume":"43","author":"Kalita","year":"2020","journal-title":"J Spinal Cord Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e355","DOI":"10.1212\/NXI.0000000000000355","article-title":"Elsberg syndrome: a rarely recognized cause of cauda equina syndrome and lower thoracic myelitis","volume":"4","author":"Savoldi","year":"2017","journal-title":"Neurol Neuroimmunol Neuroinflammation."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1001\/archneur.58.9.1460","article-title":"Nonpoliovirus poliomyelitis simulating Guillain-Barr\u00e9 syndrome","volume":"58","author":"Gorson","year":"2001","journal-title":"Arch Neurol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e924","DOI":"10.1212\/NXI.0000000000000924","article-title":"Overlapping central and peripheral nervous system syndromes in MOG antibody\u2013associated disorders","volume":"8","author":"Rinaldi","year":"2020","journal-title":"Neurol Neuroimmunol Neuroinflammation."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.1212\/WNL.0b013e3182703ff7","article-title":"Two cases of lumbosacral myeloradiculitis with anti-aquaporin-4 antibody","volume":"79","author":"Takai","year":"2012","journal-title":"Neurology."},{"key":"B17","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.msard.2017.09.006","article-title":"Radiculopathy in neuromyelitis optica. How does anti-AQP4 Ab involve PNS?","volume":"18","author":"Kim","year":"2017","journal-title":"Mult Scler Relat Disord."},{"key":"B18","doi-asserted-by":"publisher","first-page":"102557","DOI":"10.1016\/j.msard.2020.102557","article-title":"A case of anti-AQP4 antibody-positive neuromyelitis optica spectrum disorder with MRI-proven lesions in lumbar nerve roots","volume":"46","author":"Toru","year":"2020","journal-title":"Mult Scler Relat Disord."},{"key":"B19","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1001\/jamaneurol.2018.4053","article-title":"Clinical, radiologic, and prognostic features of myelitis associated with myelin oligodendrocyte glycoprotein autoantibody","volume":"76","author":"Dubey","year":"2019","journal-title":"JAMA Neurol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1212\/WNL.0000000000000101","article-title":"Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders","volume":"82","author":"Sato","year":"2014","journal-title":"Neurology."},{"key":"B21","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1017\/S1092852900013845","article-title":"Acute transverse myelitis and Guillain\u2013Barre overlap syndrome following influenza infection","volume":"13","author":"Tripp","year":"2008","journal-title":"CNS Spectr."},{"key":"B22","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/j.1469-0691.2006.01636.x","article-title":"Preceding infections and anti-ganglioside antibodies in patients with Guillain\u2013Barr\u00e9 syndrome: a single centre prospective case-control study","volume":"13","author":"Sinha","year":"2007","journal-title":"Clin Microbiol Infect."},{"key":"B23","doi-asserted-by":"publisher","first-page":"S161","DOI":"10.3345\/kjp.2016.59.11.S161","article-title":"Concurrency of Guillain-Barre syndrome and acute transverse myelitis: a case report and review of literature","volume":"59","author":"Tolunay","year":"2016","journal-title":"Korean J Pediatr."},{"key":"B24","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.pediatrneurol.2007.05.020","article-title":"Concomitant transverse myelitis and acute motor axonal neuropathy in an adolescent","volume":"37","author":"Howell","year":"2007","journal-title":"Pediatr Neurol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1038\/cmi.2017.142","article-title":"Guillain\u2013Barr\u00e9 syndrome, transverse myelitis and infectious diseases","volume":"15","author":"Rodr\u00edguez","year":"2018","journal-title":"Cell Mol Immunol."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.721669\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T06:55:28Z","timestamp":1629356128000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.721669\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,19]]},"references-count":25,"alternative-id":["10.3389\/fneur.2021.721669"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.721669","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2021,8,19]]},"article-number":"721669"}}