Syringomyelia: symptoms, causes and treatment

There are many conditions or disorders that are related to abnormalities in the flow of cerebrospinal fluid and the appearance of cysts or malformations in the spinal cord. In addition, on many occasions these are asymptomatic and imperceptible, which means that they continue their development without the person noticing it.

One of these disorders that affects the bone marrow is syringomyelia., a disorder that, although at the beginning it does not manifest any clinical picture, can cause major motor and sensory complications.

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What is syringomyelia?

The disease known as syringomyelia is an organic condition that causes the appearance of a cyst located inside the spinal cord. This protuberance, which is filled with an aqueous fluid, is known as the syrinx or syrinx.

This disease develops gradually, so that the syrinx gradually increases its size, expanding inside the spinal cord and causing extensive damage in the center of it. Because the spinal cord is connected to the nerves that control the extremities,

syringomyelia tends to cause pain, weakness, and stiffness in the extremities, back, and shoulders.

In addition, people who suffer from it also often suffer from other symptoms such as severe headaches or sensory symptoms such as changes in thermal perception. However, the symptoms can be very varied and affect patients in very varied ways, even not generating any type of symptom.

The germ or reason why these types of cysts appear is related to several factors. The most common of these is the appearance of an abnormality known as Chiari malformation, a malformation that causes brain tissue to bulge into the spinal canal. Likewise, other causes of syringomyelia can be the appearance of tumor masses in the medulla, or an injury or inflammation of it.

Regarding the incidence of syringomyelia, traditionally, this has been quite difficult to calculate because it shares a multitude of symptoms with other diseases, which makes it difficult to diagnosis. However, thanks to advances in diagnostic tests using neuroimaging, its detection has improved.

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What symptoms does it present?

As mentioned in the previous point, syringomyelia is a disease of gradual development in which the symptoms tend to appear once adulthood has begun. In cases where it is due to a Chiari malformation, these begin to manifest between 25 and 40 years of age.

On other occasions, the symptoms may appear abruptly or suddenly when the patient experiences strong coughing attacks or after making intense physical effort. However, it does not mean that these are the causes of the disease.

The clinical picture of syringomyelia mainly affects neck, shoulders, arms and hands, but over time it ends up spreading, also affecting the lower extremities.

Between the main symptoms of syringomyelia are included:

• Muscular atrophy characterized by weakness and wasting of the muscles.
• Diminished and lost reflexes.
• Altered sensitivity to pain and temperature.
• Stiffness in neck and extremities.
• Sensation of pain due to stiffness.
• Muscle spasms in lower extremities.
• Alteration in gastrointestinal functioning.
• Spine disorders such as scoliosis.

Although in many cases this may not cause any type of symptom, due to its gradual progression, syringomyelia It can become a disease with very serious health complications of the person. These complications have their origin in an excessive growth of the syrinx.

This growth tends to injure certain groups of nerves in the spinal cord, generating the following symptoms:

• serious motor problems in the legs that interfere with the ability to walk
• Chronic and high intensity pain
• Scoliosis or pathological curvature of the spine.

What are the causes?

Although syringomyelia can be caused by traumatic, infectious or tumor agents, the truth is that in most cases it is practically impossible to determine the specific origin of this disease.

When said disorder is caused by some other disease or condition, the lesions that these cause can hinder the flow of blood. cerebrospinal fluid. As a consequence, it moves towards the spinal cord, forming the aforementioned syrinx.

As for the diseases that can cause this type of cysts, they include:

• Masses or tumor formations in the spinal cord.
• Meningitis or inflammation of the membranes of the brain and spinal cord.
• Chiari malformation.
• Spinal cord injuries.
• Spinal disorders present at birth.

How can it be diagnosed?

Since syringomyelia does not manifest any type of symptom in its early stages, it is very likely that this is detected accidentally when the person undergoes an evaluation for some other disease.

However, because the symptoms coincide with those of many other conditions of a similar nature, the doctor performs a thorough evaluation that allows him to rule out other diseases.

A good diagnosis of syringomyelia implies that the professional performs a complete and detailed medical history, accompanied by a physical examination. For this, magnetic resonance images of the spinal cord and spinal cord may be used, as well as a exploration by means of a computerized axial tomography which facilitates a detailed image of the area affected.

Is there a treatment?

Intervention guidelines for the treatment of syringomyelia are subject to both the severity of the symptoms and the condition or disease that causes it.

In those cases in which it is not related to any other disease and, in addition, the patient does not manifest any serious signs or symptoms, it will only be necessary to carry out periodic controls through resonances and neurological evaluations.

However, when syringomyelia causes great discomfort or interferes with the patient's daily life, surgical intervention is recommended. Through a small surgical intervention, the pressure exerted by the cyst on the spinal cord is decreased, which mitigates the severity of the symptoms.

The type of intervention may depend on the main cause of the cyst formation, which can range from drainage of this, the removal of the tumor mass that forms the obstruction or the correction and treatment of the anomaly that forms the syringomyelia.