[Acute paraparesis associated with dorsal diastematomyelia in an adult].

Diastematomelia presenting in adult life has long been considered a rare occurrence. With the development of modern imagining techniques, cases of adult are being discovered with increasing frequency, but their exact number remains unclear. It occurs most often in the lumbar region, is rarely located above the level of T3 and it present clinical features such as deformity of the food, peculiar posture, or gait disturbance. The symptoms and signs of diastematomelia usually are recognized in children. We are reporting the case of an adult patient who had a forme frustre of Sjögren's syndrome and thoracic diastematomelia presenting as a acute myelopathy. Although in most of patients, the pathogenesis of the neurological deficits could be attributed to lesions such as spondylosis, herniation of a disc, traction injury or the tethering effect derived from an osseous septum or a fibrous band, in our patients was absent. We suggested as contributory cause to damage of the spinal cord a vascular ischemic mechanism during flexion and extension of the spine, and we postulated the role that anti-Ro (SS-A) antibodies play in the immunopathogenesis (mediating or potentiating) vascular injury by altering vascular endothelial function or proliferation.