A 17 years old female was first seen in a neurology department in December 75. She was running a low grade fever; her general status was not good. At the physical examination she presented:--an amyotrophy of both arms, mainly proximal,--a thermo analgesic dissociation which was complete from C1 to C5 and incomplete from C5 to D4, and--a spastic quadriparesis (with a posterior spinal syndrome). The first physical disabilities appeared 15 months before. The myelography revealed an enlarged spinal cord in the upper part of the cervical region and the contrast media could not go through the foramen magnum. At surgery, a solid mass, localized on the right side, inside the medulla oblongata and the spinal cordal, with a cyst at each extremity, reaching C4 in the lower part and the recessus lateralis in the upper part. During surgery the patient was breathing spontaneously. After the removal of the mass, she presented an apnea. The quadriplegia following surgery was very short. She recovered rapidly a normal motor activity in both legs and in the right arm. Respiratory paralysis remained complete for 2 months. The right diaphragm recovered completely in 4 months, the left one only in part. 4 months after surgery, she went back home. One year later for security reason she still has a tracheotomy. The distal paralysis of the left superior arm is still present.

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