It is a disorder characterized by the presence

of a cyst or cavity in the central part of spinal

cord ,the cyst called as syrinx. When it affect
the brainstem, the condition is called
syringobulbia.
HISTORY

It usually progresses slowly .symptoms depend primarily on

the location of the lesion within the neuraxis. Clinical
manifestations include the following:

Sensory: Dissociated sensory loss

Motor: Damages the motor neurons & cause muscle
atrophy
 Autonomic: Impaired bowel & bladder functions, sexual
dysfunction may develop in long-standing cases.
 Extension of syrinx: A syrinx may extend in to medulla
producing syringobulbia
 Other manifestations: painless ulcers, edema, neurogenic
arthropathies. Scoliosis is seen sometimes. Acute painful
enlargement of shoulder associated with destruction of
head of humerus.
PHYSICAL

Diminished arm reflexes

Lower limb spasticity, paraparesis, hyperreflexia,
Dissociated sensory impairment
Brainstem signs are common
The syrinx may extend in to the brainstem affecting cranial
nerves or cerebellar function
 SYRINGOMYELIA WITH FOURTHVENTRICLE
COMMUNICATION.
 DUE TO BLOCKAGE OF CSF CIRCULATION.
 DUE TO SPINALCORD INJURY.
 SYRINGOMYELIA & SPINAL DYSRAPHISM.
 DUE TO INTRAMEDULLARY TUMORS.
 IDIOPATHIC.
Estimated prevalence of disease is about 8.4 cases/100000
people.
SEX – More frequently in men than women
AGE – Usually beginning in young adulthood
1. ETIOLOGY ASSOCIATED WITH CRANIOVERTIBRAL
JUNCTION ABNORMALITIES:
a) Bony abnormalities.
b) Soft tissue masses of abnormal nature.
c) Cerebellar tonsils.
d) Chiari malformation.
e) Membranous abnormalities such as arachnoid cyst, vascularised
membranes.
2. ETIOLOGY NOT ASSOCIATED WITH
CRANIOVERTEBRAL JUNCTION
ABNORMALITIES

a)Arachnoid scarring related to spinal trauma.

b)Arachnoid scarring related to meningeal inflammation.
c)Arachnoid scarring related to surgical trauma.
d)Sub arachnoid space stenosis due to spinal neoplasm.
e)Idiopathic.
 Patients may experience chronic pain, abnormal
sensations and loss of sensation particularly in hands. Syrinx
may also cause disruptions in parasympathetic and
sympathetic nervous system, leading to abnormal body
temperature or sweating, bowel control issues.
In case of syringobulbia, vocal cord paralysis, tongue
wasting, trigeminal nerve sensory loss. Rarely bladder stones
can occur .
 NEUROSURGEON
 PSYCHIATRIST
 UROLOGIST
 PHYSIOTHERAPIST
 OCCUPATIONALTHERAPIST
 RECREATIONALTHERAPIST
MAGNETIC RESONANCE IMAGING [MRI]
This will show the syrinx in the spine, or presence of a tumor.
 ELECTROMYOGRAPHY [EMG]
This measures the muscle weakness.
 COMPUTED AXIAL TOMOGRAPHY [CT]
Shows the presence of tumors.
MYELOGRAM
Syrinx seen as a thin light grey shape, inside the spinalcolumn
MEDICATIONS
NSAIDs – Ibuprofen[1200-1800mg po-6h]
Aspirin[325-650mg po -6h]
Naproxen, Indomethacin,Pioroxicam,
Mefenamicacid.
MUSCLE RELAXANTS
Methocarbamol[1.5gm po qid ]
SURGICAL CARE
Sub occipital cervical decompression
Laminectomy and Syringotomy
Shunts
Fourth ventriculostomy
Neuroendoscopic surgery
Percutaneous needle
 Syringomyelia is a disorder in which a cyst or cavity
forms within the spinal cord. The exact pathophysiology
is unknown. It can be diagnosed by MRI, EMG, CT scan.
No medical treatment is given. Identifying the underline
cause of Syrinx formation is very important. The
management of pain due to Syringomyelia is best
accomplished by a multi-disciplinary approach.

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