Introduction
Amyotrophic lateral sclerosis is progressive absolutely fatal neurodegenerative disease that affects the upper and lower motor neurons. Disease begins with focal weakness and spreads to involve most muscles, including the diaphragm. Usually death occurs due to respiratory failure in 3 to 5 years [1]. Despite excessive researches on ALS biomarkers, diagnosis is based on clinical presentation and supported by EMG [2]. MRI basically is used to exclude ALS mimics, which helps in diagnosis.
We present clinical case of 36 years old male patient suffering ALS for 6 years with accidentally revealed slit-like syrinx cavity and looking as dilated central canal of the thoracic spinal cord, and clinical case of 61 years old female patient with ALS and dilates central canal of the cervix spinal cord. In the presented cases, patients with ALS were diagnosed with hydromyelia using MRI even before the typical fulfill clinical manifestation of ALS has developed, which led to a delay and difficulty in making a correct diagnosis. Such combination of ALS and hydromyelia has not been reported before. Here we discuss the differential diagnosis and suppose the causes of the central canal dilation in our cases.