CLINACASE

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ID: 266
Category: Neurological Disorder
CreatedBy: 1
UpdatedBy: 1
createdon: 17 Jun 2023
updatedon: 17 Jun 2023

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Author: Khoa Tran
Published Jun 17, 2023
Updated Jun 17, 2023

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Syringomyelia

Etymology and Pronunciation

syringomyelia (sur-ing-go-my-EEL-ya)
syrinx - Greek for "tube" or "pipe"
myelos - Greek for "marrow" or "spinal cord"

History of Syringomyelia

In the 16th century, Charles Estienne, a French anatomist, made a remarkable observation regarding the spinal cord. According to available records, Estienne became the first to witness cavitation within the spinal cord in a cadaver. However, it is worth noting that an earlier account by Carolus Stephanus in 1545 has been mentioned, which bears striking similarity to Estienne's findings. Stephanus wrote in Latin, while Estienne, a year later, documented his observations in French.

In 1688, Johann Conrad Brunner reported a case involving an infant afflicted with hydrocephalus. During his examination, he discovered a cavity filled with cerebrospinal fluid within the spinal cord. This finding provided further evidence of the intricate nature of spinal cord abnormalities.

In 1824, Ollivier d' Angers, introduced the term "syringomyelia" to describe a peculiar condition characterized by a tubular dilatation within the spinal cord. This cavity was found to communicate with the fourth ventricle, and Ollivier believed it to be a dilation of the central canal.

Advancements in the understanding of spinal cord cysts and their classification continued into the 18th and 19th centuries. Oskar Schüppel proposed a distinction between two conditions: hydromyelia and syringomyelia. Schüppel suggested that the persistence and dilatation of the fetal central canal should be referred to as hydromyelia. Meanwhile, the term syringomyelia should be reserved for cysts that were not connected to the central canal. The distinction between these two conditions was initially believed to lie in the differences observed in the lining cells of these cavities. Hydromyelic cavities were thought to be lined by ependymal cells, while syringomyelic cavities were believed to be lined by glial cells.

In the mid-20th century, new imaging techniques were developed that allowed for even more detailed visualization of the body's internal structures. These included computed tomography (CT) and magnetic resonance imaging (MRI). CT scans use X-rays and computer technology to create detailed, 3D images of the body, while MRI uses powerful magnets and radio waves to create images of the body's tissues and organs. Imaging technology allow physicians to visualize and diagnose the internal structure of the human body without the need for invasive procedures, such as surgery.

Modern Understanding of Syringomyelia

Syringomyelia is a condition that occurs when a fluid-filled cavity called a syrinx forms within the spinal cord. This cavity can expand over time and cause damage to the spinal cord, which can lead to a variety of symptoms.

The symptoms of syringomyelia can vary widely depending on the location and size of the syrinx. Some people with syringomyelia may experience chronic pain in the neck, shoulders, and arms. Others may develop weakness or numbness in their limbs, while some may experience problems with bladder or bowel function.

Syringomyelia is typically diagnosed through magnetic resonance imaging (MRI) scans, which can show the location and size of the syrinx in the spinal cord.

Causes of Syringomyelia

The exact cause of syringomyelia is not fully understood, but there are several factors that are believed to contribute to its development.

One of the primary causes of syringomyelia is a blockage of the normal flow of spinal fluid, which can occur as a result of a variety of different factors. This obstruction can lead to the accumulation of fluid in the spinal cord, which can cause damage to the nerves that control motor function, sensory perception, and other vital bodily processes.

Other factors that can contribute to the development of syringomyelia include trauma to the spinal cord, inflammation or infection, congenital abnormalities, and tumors or other growths in the spinal cord. In some cases, syringomyelia may be associated with other medical conditions, such as spinal stenosis or Chiari malformation.

While the exact cause of syringomyelia is not fully understood, researchers and healthcare professionals continue to work to better understand the condition and develop effective treatments to help those who are affected by it.

Treatments for Syringomyelia

Syringomyelia is a condition that affects the spinal cord, and its treatment depends on the underlying cause. Treatment options may include surgery, medication, and physical therapy.

Surgery is often the primary treatment for syringomyelia. The goal of surgery is to remove any blockages or growths in the spinal cord that may be causing the condition. The type of surgery may vary depending on the individual case and the severity of the syringomyelia.

Medication may also be used to manage the symptoms of syringomyelia. This may include pain relief medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) or stronger opioids, which can help alleviate chronic pain associated with the condition.

Physical therapy can also be beneficial for patients with syringomyelia. A physical therapist can help develop a customized exercise plan to improve mobility, strengthen muscles, and improve overall physical function.

It's important to note that treatment for syringomyelia may vary depending on the individual's needs and the root cause of the condition. Therefore, it's recommended to consult with a medical professional to determine the most effective course of treatment for one's specific condition.

Symptoms

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Loss of sensitivity to temperature and pain
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Weakness, cramping, or numbness in the legs
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Pain in lower back, legs, or arms
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Back pain
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Difficulty breathing
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Muscle spasms
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Muscle stiffness

Confirmation Tests

- CT scan
- MRI
- X-rays

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