Signs and Symptoms of Syringomyelia

Signs and Symptoms

 

Dissociated sensory loss - pain and temperature are disrupted whereas light touch, proprioception, and vibratory sensation are often unaffected. Sensory disturbance is almost always asymmetric in a cape-like over the shoulders and back. Pain is frequently felt in the neck and shoulders.

Central Cord Syndrome: Centrally located syrinx, that injures the fibers located centrally (cervical) before the fibers located laterally (thoracic, lumbar, and sacral, in this order) in the spinal cord. A cervical syrinx often results in early symptoms (sensory loss and motor weakness) of the more distal muscles of the fingers and hands followed by late signs in the proximal muscles of the shoulders, trunk, and later the legs. A thoracic syrinx may cause motor weakness and sensory disturbance of the trunks followed by the legs.  

Brainstem symptoms and signs: When the syrinx extends into the brainstem (syringobulbia), symptoms are common early on in the process. These usually consist of dysfunction of the lower cranial nerves with coughing, aspiration, and dysphagia.

Scoliosis: May result from unequal weakness of the spinal muscles. Young age, atypical curve, rapid curve progression, and back pain associated with scoliosis should alert one to the possible role of syringomyelia.⁹

Chronic pain: is associated with a variety of chronic pain syndromes, particularly in posttraumatic syringomyelia, in which there is an initial traumatic injury followed by later spinal cord injury secondary to syrinx distention; however, while it is nearly impossible to determine if the pain is caused by the syrinx or the primary pathology, it appears that treatment of the syrinx rarely results in resolution of the pain, which suggests that the pain may be related to the initial spinal cord injury.