Syncope in a Patient With an Extensive Thoracolumbosacral Myxopapillary Ependymoma

Myxopapillary ependymomas are most commonly found involving the conus medullaris, cauda equina, and filum terminale, causing lower extremity symptoms, whereas atypical presentations such as syncope are rare. A 20-year-old woman presented with multiple syncopal episodes, headache, visual changes, and lower extremity paresis. Imaging revealed a T10-S2 myxopapillary ependymoma and mild ventriculomegaly. The patient underwent subtotal debulking, and histopathologic examination confirmed a WHO Grade II myxopapillary ependymoma. Postoperatively, her symptoms resolved. This case highlights the importance of evaluating spinal pathology in patients with atypical presentations of syncope.