Introduction:
- Syringomyelia is a rare disorder in which a cyst forms within spinal cord
- As this fluid-filled cyst, or syrinx, expands and lengthens over time, it compresses and damages part of the spinal cord from its center outward.
MC site: Lower cervical cord (Ref.: Harrison 20th)
Causes:
- Congenital
- Acquired: Trauma/ TB/ tumor
- Associations: May be associated with both Chiari type1 & type 2 malformations; but more than half of all cases are associated with Chiari type 1 malformations in which the cerebellar tonsils protrude through the foramen magnum and into the cervical spinal canal.
Characteristic clinical features:
- Asymmetric selective loss of pain and temperature sensation with sparing of touch and vibration → Dissociated anesthesia (Read more)
- Painless burn injury to the hand
- May be associated with Charcot joint (Painless progressive destruction of joint)
- Cape like distribution of sensory loss
- At the level of lesion: LMN type of paralysis
- Below the level of lesion: UMN type of paralysis
- As the cavity enlarges and compresses the long tracts, spasticity and weakness of the legs, bladder and bowel dysfunction, and a Horner’s syndrome appear.
IOC: MRI
Rx: Decompressive laminectomy.