SYRINGOMYELIA

SUMMARY

1. Syringomyelia is a progressive myelopathy caused by cavitation of the central spinal cord, typically in the cervical region but may extend into the thoracic region.

2. It can be idiopathic, developmental, or acquired. About 2/3 of cases are associated with Arnold-Chiari malformation.

3. Most common presenting symptom is pain: aching or burning, often worse with coughing, sneezing, straining, and usually in the sitting rather than in the supine position.

3. Other symptoms: painless weakness and wasting of the hands and arms (brachial amyotrophy) and segmental sensory loss of dissociated type in a "cape-like" pattern, AD, worsening spasticity, respiratory depression & diaphragmatic paralysis, new Horner's syndrome.

4. Sensory loss of disassociated type (loss of pain & temperature sensation with sparing of tactile, joint position, and vibration sense) is due to involvement of the crossing spinothalamic fibers in the central part of the cord.

5. When the anterior horn cells are affected, with lateral expansion of the syrinx, weakness and atrophy of the upper limbs occur, starting in the hands and moving proximally.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.