What is Syringomyelia?

Causes
Syringomyelia can be caused by, or be a complication of:

• Birth defects, such as Chiari I malformation*
  
• Hemorrhage (bleeding)
  
• Inflammation of the spinal cord (e.g., meningitis)
  
• Spinal cord injury (trauma)
  
• Spinal cord tumor

*Chiari I malformation develops during the fetal developmental stage and causes the lower part of the brain (cerebellum) to protrude from its normal location.

Symptoms
As the body's connection to the brain, a damaged spinal cord interrupts the brain's ability to communicate. Although each patient's symptoms differ, common syringomyelia symptoms include:

• Pain, stiffness, or weakness in the neck, arms, back, and/or legs
  
• Progressive numbness
  
• Headache
  
• Sensitivity to heat and cold
  
• Muscle wasting, contractions, spasticity (tight muscles)
  
• Skin rash

Symptoms usually develop slowly, yet exercise, coughing, or otherwise straining can bring on a sudden onset.

Diagnosis
A physical and neurologic examination may reveal loss of feeling or an inability to move normally (such as walk). Diagnostic tests of the spine may include a CT scan with contrast dye or an MRI. Early syringomyelia detection is crucial, as a delay in treatment can cause irreversible spinal cord injury. At the first sign of symptoms, contact your doctor.

Treatment
Some patients who have syringomyelia may have no symptoms; for these patients, the physician may choose a "watch and wait" approach. These patients can go about their normal lives, being cautious about avoiding cervical (neck) and back strain.

Pregnancy and vaginal delivery can be a relative contraindication for patients with syringomyelia. Pregnant patients may require special care because pushing and straining during vaginal delivery can potentially enlarge a syrinx. Although a C-section may be recommended, patients should have a full discussion with their obstetrician.

For patients experiencing symptoms of syringomyelia, the primary treatment goals are to stop or control damage to the spinal cord, preserve function, and prevent disability. Treatment options include draining or surgical removal of the syrinx. Physical therapy may be included in the treatment plan to help the patient rebuild lost muscle strength and regain flexibility.