SYRINGOMYELIA

                                                       

                                                                      INTRODUCTION

Syringomyelia is a term derived from Greek word. 'Syrinx' means tube or cavity and 'myelos' means spinal cord. Hence it is characterised by elongated cavities lining close to the central canal surrounded by glia. These are often extended upwards to the medulla leading to syringobulbia. 

                                                                  ETIOLOGY

1. CONGENITAL:- In this, there is malformation of the cerebellum which protrude out from its original position to the cervical or neck portion of the spinal cord.

2. ACQUIRED:- Due to trauma, meningitis, hemorrhage, tumour. Here the cyst is formed in spinal cord by one of these cause.

                                                                  PATHOLOGY

CSF serves to cushion the brain. Excessive CSF in the central canal of the spinal cord dissects into the surrounding white matter and form a cystic cavity or syrinx.

The usual age of onset is 25-40 years but it may be as early as 10 years and as late as 60 years.

                                                             SIGN AND SYMPTOMS

Most characteristic symptoms are Anaesthetia i.e. loss of sensation of pain and temperature, but not of touch, vibration or motor. This is due to uninvolvement of posterior column until late.

Muscular atrophy and paralysis occurs as soon as anterior horn cells are subjective to pressure.

The patient usually notices slow onset of wasting and weakness of one hand which may be progress upward upto the trunk.

Feet are also involved but later.

DTR(deep tendon reflexes) are diminished or lost.

Analgesia and thermoanaesthetia have segmental distribution involving 1st ulner side, then radial side and then neck and chest.

Occular paralysis leading to ptosis and smaller pupil.

In severe or chronic cases, ataxia or spastic paraplegia is also seen.

                                                                    SYRINGOBULBIA

👉  Involvement of medulla also

👉  nystagmus present

👉  vertigo present

 👉 motor function of cranial nerve may also be seen.

                                                            TREATMENT

Surgery is the treatment of syringomyelia. Physiotherapy treatment is same as we do for a spinal cord injury patient. We will improve muscle power, patient education, frankel exercises for balance, prevt secondary complications, etc.