Symptoms of syringomyelia, early treatment when signs are found

Syringomyelia causes different symptoms due to the different locations and sizes of the cavities. Generally, the most common site is the spinal cord at the junction of the cervical and thoracic regions. In the early stages, pain symptoms will appear in the corresponding areas, as well as symptoms of decreased muscle tone, and treatment is required as soon as possible.

1. This disease is more common in people aged 20 to 40, and more common in men than in women . Clinical symptoms progress very slowly. Due to the different locations, sizes and ranges of the cavities, the symptoms are also inconsistent. The most common site of the cavity is in the spinal cord at the junction of the cervix and thoracic region. Early symptoms are mostly spontaneous pain in the corresponding distribution area (the cavity begins at the bottom of the posterior horn of the gray matter on the dorsal side of the central canal), segmental dissociated sensory impairment, gradually expanding to the upper limbs and chest and back, with a short-shirt-like distribution of decreased or absent pain and temperature sensation, while touch and deep sensation are preserved. Patients often seek medical treatment when they find that they have no pain after injury. In the late stage, the syrinx extends to the spinothalamic tract, and conduction tract sensory disturbances occur below the level of the syrinx.

2. When the anterior horn cells are affected, the corresponding segmental muscle atrophy, muscle fasciculations, decreased muscle tone and weakened tendon reflexes will occur. When the cavity is located in the cervical enlargement, muscle atrophy of both hands will be obvious. Pyramidal tract signs appear below the level of the cavity, and Horner's sign appears if the lesion invades the lateral sympathetic nerve center of the 8th cervical nerve to the 1st thoracic nerve.

3. Loss of joint pain sensation can lead to neurogenic arthropathy , joint wear, atrophy and deformity, joint swelling, increased range of motion, friction sound but no pain during movement, namely Charcot joint. Skin nutritional disorders are also common, such as skin thickening, excessive keratinization, burns and cuts on the epidermis in the area of ​​loss of pain causing stubborn ulcers and scar formation, and even painless necrosis and shedding of the ends of the fingers and toes (Morvan sign). In late stages, neurogenic bladder and urinary and fecal incontinence may occur.

4. Syringomyelia rarely occurs alone. It is often an extension of the syringomyelia , which is often asymmetric and the symptoms and signs are mostly unilateral. When the cavity involves the spinal nucleus of the trigeminal nerve, onion-skin-like loss of pain and temperature sensation on the face occurs, which develops from the outside to the nasolabial area; when the nucleus ambiguus is involved, dysphagia and coughing when drinking water are caused; when the hypoglossal nucleus is involved, the tongue is deviated to the affected side, and the ipsilateral tongue muscles atrophy and fasciculations occur; when the facial nerve nucleus is involved, peripheral facial paralysis occurs; and when the vestibulocerebellar pathway is involved, dizziness, nystagmus and unsteady gait occur.