Syringomyelia is a disorder in which a fluid-filled cyst forms in the spinal cord. Called a syrinx, the cyst grows over time. It most commonly starts in the area of the neck, but it can extend down along the entire length of the spinal cord. The cyst ultimately destroys the center of the spinal cord.
Early on the cyst disrupts the body's ability to feel pain or temperature. This leads the patient to overlook dangerous conditions that may result in burns or cuts.
The first symptoms tend to appear in the fingers and then spread. It is common to have a loss of sensation that spreads like a cape over the shoulders and back.
Late in the condition, the affected individual may have spastic muscles or weakness of the legs.
Other symptoms can include:
- A loss in the ability to feel extremes of hot or cold, especially in the hands
- Difficulty articulating words
- Impaired sensation in the face on one or both sides
- Loss of or deficiency in the power to use or understand language
- Pain, weakness and stiffness in the back, shoulders, arms or legs
- Rapid, involuntary rolling of the eyeballs
Symptoms can occur suddenly after coughing or straining. If not treated surgically, syringomyelia often leads to more and more weakness in the arms and legs, loss of hand sensation and chronic, severe pain.
Causes and Risk Factors
About half of these cysts are due to abnormalities of the spine or skull base that were present from birth. During the teen or young adult years, these cysts often expand for unknown reasons.
The remainder of these cysts develops along with tumors, after an injury to the spine or for unknown reasons.
Other, more common disorders share the early symptoms of syringomyelia. In the past, this has made diagnosis difficult. Magnetic resonance imaging (MRI) has significantly increased the number of cases diagnosed early.
Surgery is usually recommended to make more space for the cerebellum (Chiari malformation) at the base of the skull and upper neck, without entering the brain or spinal cord. If a tumor is causing syringomyelia, removing it is usually recommended. With surgery, symptoms improve or do not get worse for most patients. Delaying treatment may cause permanent spinal cord injury.