Syringomyelia

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Syringomyelia

• at brainstem known as syringobulbia

Examination

• Observe
  • puffy cyanosed hands
  • wasting - small muscles of hands
  • Scars
    • painless burns
  • Charcot joints
    • shoulder
    • elbow
• Tone
• Power
  • Weakness of segmental (LMN) type, most marked distally
  • pyramidal weakness below syrinx
• Reflexes
  • absent in upper limbs
  • brisk below
• Sensation
  • dissociated / suspended sensory loss
  • loss of pain / temperature
  • preserved light touch / joint position sense / vibration
• Coordination
  • normal

Differential Diagnosis

• central cord tumour

Associations

• Chiari malformation
  • downbeat nystagmus
• Hydrocephalus
• Horner's Syndrome
• Kyphoscoliosis
• Spastic Paraparesis

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