Diplomyelia in a patient with a clinical suspicion of autosomal recessive spastic ataxia of Charlevoix-Saguenay type (ARSACS)
Bibliographic record
Abstract
Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a form of cerebellar ataxia related to mutations in the SACS gene on chromosome 13q12.12 encoding sacsin protein. Characteristic clinical features are ataxia, spasticity, distal muscle wasting, neuropathy, dysarthria, nystagmus, and finger or feet deformities. The presented case concerns a 32-year-old man with clinical diagnosis of ARSACS. Magnetic resonance imaging (MRI) scans of the brain revealed cerebellar atrophy typical of the disease while neuroimaging of the C1-C3 and C6-Th12 segments showed only the thin thoracic spinal cord. The patient died suddenly and a gross examination of the spinal cord revealed extraspinal tumour at the C4-C5 levels, which turned out to be an additional spinal cord. Microscopic examination showed an extensive ischemic necrosis involving C6-Th5 segments of the proper spinal cord, and disturbed intrinsic structure containing many pathological vessels of the extra spinal cord. Lack of visualization of C4-C5 spinal cord segments on MRI scans made diagnosis of diplomyelia in vivo impossible. However, diplomyelia does not exclude coexistence of ARSACS because of the occurrence of such clinical symptoms as dysarthria or nystagmus which cannot be explained by the presence of the spinal cord defect. The possibility of congenital malformations of the spinal cord in adults should be remembered as their early identification and surgical correction can improve neurological symptoms.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".