About Syringomyelia
The cause of syringomyelia is not fully understood, but there are several proposed causes. One common cause is Chiari malformation, where brain tissue extends into the spinal canal, obstructing the flow of cerebrospinal fluid (CSF). Other causes include spinal cord injuries, spinal cord tumors, and inflammation around the spinal cord. The exact mechanism of how CSF enters the spinal cord is still debated.
Risk factors for syringomyelia include increasing age and a positive family history of Chiari malformation or polyps. It is generally recommended to maintain a healthy weight, engage in regular physical activity, and follow a healthy diet. These lifestyle choices can have a positive impact on overall health.
It's important to note that these are general recommendations and may not directly address the prevention or management of syringomyelia. Always consult with a healthcare professional for personalized advice.
The most common early symptoms of syringomyelia include:
- Muscle weakness in the arms and legs
- Pain in the neck and shoulders
- Numbness, tingling, or burning sensations
- Decrease in or loss of sensitivity to hot and cold, particularly in the hands
- Stiffness and lack of coordination in the legs
- Scoliosis, which is a curvature of the spine
- Headaches
- Loss of balance
As syringomyelia progresses or reaches higher severity, other common symptoms that may occur include:
- Loss of bladder and bowel control
- Difficulties with sexual function
- Abnormal sensations
- Sensory disturbances or loss
- Burning type of constant pain
- Cranial nerve dysfunction
- Persistent hiccup
- Visual disturbances
- Involuntary eye movement
- Horner syndrome (a combination of symptoms including drooping eyelid, constricted pupil, and decreased sweating on one side of the face)
- Impaired breathing control
It's important to note that symptoms can vary from person to person, and not everyone will experience all of these symptoms. If you suspect you may have syringomyelia or are experiencing any concerning symptoms, it's best to consult with your healthcare professional for an accurate diagnosis and appropriate management.
To diagnose syringomyelia, healthcare providers commonly perform the following examinations, tests, and procedures:
- Medical history review: The doctor will ask about your symptoms and medical history.
- Physical exam: The healthcare provider will look for physical signs of the condition, such as pain, swelling, or masses in the body.
- Imaging studies: These may include an MRI scan or a CT scan to obtain detailed images of the spinal cord and surrounding tissues. A moving MRI scan, called a cine or dynamic MRI, can show the movement of cerebrospinal fluid and assess its flow.
- Lab tests: Blood draws or other lab tests may be ordered to check for any underlying conditions.
To determine the stage or severity of syringomyelia, additional examinations, tests, and procedures may be recommended:
- Motor and sensory tests: These evaluate movement, balance, and coordination to assess neurological function.
- Dynamic MRI: Multiple MRI images taken in rapid succession can show the flow of fluid around the spinal cord and within the syrinx. Contrast agents may be used to enhance the images.
- Clinical procedures: Depending on your symptoms and body system being evaluated, healthcare providers may recommend specific clinical procedures such as hearing tests or other diagnostic tests.
Remember that these are general descriptions. Your healthcare provider will determine which specific examinations, tests, and procedures are most appropriate for your individual situation.
The goals of treatment for syringomyelia are to eliminate the syrinx (fluid-filled cavity) and prevent further spinal cord injury. The type of treatment depends on the underlying cause and symptoms. Here are the recommended treatments and how they work:
- Surgery: The mainstay of treatment is surgery, which aims to restore normal cerebrospinal fluid (CSF) flow and drain the syrinx. There are different surgical options based on the specific situation:
- Treating associated Chiari malformation: This creates more space at the base of the skull and upper neck, reducing pressure on the brain and spinal cord.
- Dissection of arachnoid membrane: This procedure treats the origin of the disease by removing scar tissue around the spinal cord.
- Expansive duraplasty: This is a controversial procedure involving removal of scar tissue and adding a patch to expand the dura (membrane surrounding the spinal cord), restoring CSF flow.
- Removing obstructions: Surgery removes scar tissue, bone, or tumors blocking CSF flow.
- Draining the syrinx: In some cases, when there is no associated Chiari malformation or tumor, draining the syrinx may be necessary.
- Health behavior changes: It is advised to avoid activities that involve straining, as they can trigger symptoms. Limiting heavy lifting and avoiding activities that strain the body can help manage symptoms.
- Medication: Pain relief medication can be used to alleviate any pain experienced. However, medication alone cannot eliminate or treat syringomyelia. Ask your doctor about appropriate pain relief options.
- Physical therapy: Some individuals may benefit from physical therapy to improve strength, flexibility, and overall function.
These treatments aim to eliminate the syrinx, restore normal CSF flow, relieve pressure on the spinal cord, and improve symptoms associated with syringomyelia. Remember to consult with your healthcare professional for personalized advice as individual situations may vary.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.