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Case Description: We present the case of a 58-year-old male with a history of human immunodeficiency viruses (HIV) presenting with an 8-month history of paresthesia and burning sensation through anterior and posterior thigh. On examination, a significant level of specificity was noted in bilateral lower extremities. There was also a sustained clonus in the left ankle and hyperreflexia bilateral lower extremities. Magnetic resonance imaging studies revealed syrinx extending from T7 to T9 with maximal dilatation with concomitant myelomalacia from T2 to T9.
Setting(s): An outpatient setting Patient: A 58-year-old male with a past medical history of HIV. Assessment/Results: No surgical intervention was recommended due to concern for the development of a new deficit likely in proprioception that will negatively impact functionality including the patient's gait. Symptoms were treated with pharmacotherapy and physical therapy for spasticity management and functional mobility.
Discussion(s): To our knowledge, this is the first case report of syringomyelia in a patient with HIV in Rehabilitation Medicine literature. Syringomyelia is a condition characterized by the formation of syrinx which is a fluid-filled system within the spinal cord parenchyma. While the exact pathogenesis remains debated, it has been known to be associated with Arnold-Chiari malformation, intramedullary tumors, spinal trauma, and arachnoiditis (well established in literature). However, the association between HIV and syringomyelia lack published information.
Conclusion(s): It is suspected that HIV might play a role in developing spontaneous syringomyelia in a non-traumatic setting, without Arnold Chiari malformation or other previously known associated conditions. Even though this case is exceedingly rare, clinicians should consider its probability and provide individualized restorative treatment plans to optimize functionality