What Is Syringomyelia?
When an individual has syringomyelia, a fluid-filled cyst called a syrinx develops inside the spinal cord. The nerve fibers that transmit information from the brain to the rest of the body and vice versa can become compressed and injured when the syrinx grows larger and extends over time. Cerebrospinal fluid is the substance in the cyst. The brain and spinal cord are typically surrounded and shielded by this liquid. A short central canal that spans the length of the spinal cord is filled with cerebrospinal fluid, as are the connecting chambers in the middle of the brain, known as the ventricles.
If an individual has syringomyelia, cerebrospinal fluid builds up inside the spinal cord's tissue, widening the central canal and creating a syrinx. A syrinx typically appears when the regular cerebrospinal fluid movement around the spinal cord or lower brain stem is impeded. Syringobulbia is the term for the disorder that results when syrinxes impact the brain stem. Syringomyelia frequently affects the top regions of the spinal cord, which are the cervical and thoracic regions.
Syringomyelia is typically discovered in individuals between the ages of 20 and 50; however, it can also appear in infants or elderly persons. Around eight out of every 100,000 persons are affected by it, and it may cause up to five percent of cases of paraplegia (the paralysis of the lower torso and legs).
What Causes Syringomyelia?
The majority of occurrences of syringomyelia are linked to Chiari malformation, an abnormality in which brain tissue spreads through the foramen magnum at the base of the skull and into the spinal canal, obstructing the passage of cerebrospinal fluid. Inflammation surrounding the spinal cord, spinal cord tumors, and injuries from those may also result in syringomyelia. Sometimes there is no known cause, and it is idiopathic in nature.
What Are the Various Variations of Syringomyelia?
Syringomyelia comes in two main varieties:
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Congenital Syringomyelia: It is often referred to as communicating syringomyelia, is most frequently brought on by a Chiari malformation, and the syrinx that results is present typically in the cervical (neck) area of the spine. Typically, symptoms appear between the ages of 25 and 40. Congenital syringomyelia patients may also develop hydrocephalus, which is an accumulation of extra cerebrospinal fluid (CSF) in the brain with the expansion of the ventricles that link them. When someone tenses or coughs, the pressure inside their head and brain increases, which can result in headaches or even a loss of consciousness. One of the three membranes that protect the spinal cord, the arachnoid, may become inflamed in some persons with a condition known as arachnoiditis.
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Acquired Syringomyelia: A spinal cord injury, meningitis (inflammation of the membranes surrounding the brain and spinal cord typically brought on by an infection), arachnoiditis, tethered cord syndrome (a condition present at birth which leads the spinal cord to aberrantly linked to the tissues in the lower spine, restricting its movement), and a spinal cord tumor can all lead to acquired syringomyelia, also known as non-communicating syringomyelia or primary spinal syringomyelia.
What Are the Symptoms of Syringomyelia?
The size and location of the cyst affect the symptoms. It can harm the spinal cord's central nerves over time if it gets longer and wider. Chronic pain that is challenging to cure may result from this. Symptoms typically develop gradually over several years. However, they can appear out of nowhere following an incident like a fall. Other signs one can experience include:
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Scoliosis (the condition where the spine curves).
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Altered or lost bladder or bowel function.
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Having no sensation of heat or cold in the fingers, hands, arms, or upper chest.
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Deterioration of reflexes.
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Muscle tightness could make walking difficult.
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Experiencing tingling, numbness, burning, or piercing.
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Fluctuations in blood pressure.
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Neck, shoulders, and occasionally arms and hands pain.
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Sexual issues.
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Weakness in the muscles, particularly in the hands, arms, and shoulders.
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Paralysis.
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Twitches are uncontrollable muscular contractions.
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Uncoordinated actions.
Individuals could develop what medical professionals refer to as Horner syndrome if the cyst harms a nerve that regulates the muscles in the eyes and face. On the side of the face affected, it results in droopy eyelids, a narrowing of the space between the eyelids, smaller pupils, and less perspiration.
How to Diagnose Syringomyelia?
A doctor will perform a thorough physical examination and inquire about the medical history. Syringomyelia may occasionally be found by chance during a magnetic resonance imaging (MRI) scan of the spine or a CT (computerized tomography) scan that was done for another reason. If the doctor thinks one has syringomyelia, they will probably have tests done like:
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Magnetic Resonance Imaging (MRI)- The most accurate method for identifying syringomyelia is to have an MRI (magnetic resonance imaging) of the spinal column and spine done. A magnetic resonance imaging (MRI) scan creates precise images of the spine and spinal cord using radio waves and a strong magnetic field. The doctor will be able to see any syrinxes that have formed within the spinal cord if an individual gets an MRI. The dye may be injected into a blood vessel in the groin, travels through blood arteries to the spine, and reveal tumors or other abnormalities. To track the development of syringomyelia, one might have to undergo a series of MRI (magnetic resonance imaging) exams over time.
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Computed Tomography (CT) Scan- A computed tomography (CT) scan creates a detailed image of the spine and spinal cord using a sequence of X-rays. It may identify tumors or other issues with the spine.
How Is Syringomyelia Treated?
The course of the condition and whether the symptoms are interfering with the life of an individual will determine how they should be treated. One might not need therapy if they have minimal or no symptoms. The neurologist will monitor the course of the illness. The doctor may advise drugs like Gabapentin which may lessen the unpleasant sensation in the shoulders and arms that usually occurs with syringomyelia if the symptoms are adversely affecting the lives of patients.
Surgery is another option for treating syringomyelia. This could entail:
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Restoring the flow of cerebrospinal fluid by releasing pressure on the spinal cord by enlarging the base of the skull and the covering of the brain.
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Removing a tumor or bone growth that is causing syringomyelia and utilizing a shunt to drain extra fluid from the syrinx.
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One might be given a course of antibiotics after surgery to avoid complications from an infection.
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Physical therapy can help strengthen the muscles in limbs that are gradually weakening, and it may also be advised by the doctor.
Conclusion
Some people may have trouble walking or develop limb weakness over time. It is hoped that these symptoms will gradually improve with physical therapy and time once the syrinx has been treated. Those who receive treatment and have a successful operation have varying prognoses. There is a chance that significant spinal cord damage could result in long-term neurological problems. Attending the doctor's follow-up appointments is crucial. Given that syringomyelia might recur, patients would want recurring magnetic resonance imaging (MRI) scans.
