Posterior column atrophy in autosomal recessive hereditary spastic paraplegia: MRI findings

Hereditary spastic paraplegia (HSP) is a heterogeneous group of hereditary disorders first described by Strümpell in 1880 characterized by degeneration of the corticospinal tracts and posterior columns of the spinal cord. In spite of the advances in our clinical and genetic understanding of HSP's, the radiological correlates of the disease were never defined. Most of the studies reporting MRI findings, describe non-specific brain abnormalities and spinal cord atrophy. We report two identical twins sisters with the diagnosis of HSP in whom MRI of the spinal cord revealed posterior displacement of the central ependymal canal suggestive of posterior column atrophy.