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SYRINGOMYELIA

Neurology

SYRINGOMYELIA

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. Presents with painless weakness and wasting of the hands and arms (brachial amyotrophy) and segmental sensory loss of dissociated type in a "cape-like" pattern.

4. Sensory loss of disassociated type (loss of thermal and painful sensation with sparing of tactile, joint position, and vibratory 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.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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