Syringomyelia – Symptoms and Causes
Overview
Syringomyelia involves the formation of a fluid-filled cyst within the spinal cord. This cyst, called a syrinx, may expand over time and potentially damage the spinal cord.
Several factors can cause this condition. A common association is with Chiari malformation, where brain tissue extends into the spinal canal. Other causes include spinal cord tumors, injuries to the spinal cord, and inflammation-related damage around the spinal area.
Management approaches vary based on symptom severity. For patients without troublesome symptoms, doctors may recommend regular monitoring without intervention. However, surgical treatment becomes necessary when symptoms significantly affect quality of life.
The progression and impact of syringomyelia differ for each person, making an individualized assessment crucial for proper care.
Signs and Symptoms
Syringomyelia symptoms typically develop gradually over time. When this condition is related to brain tissue extending into the spinal canal (known as a Chiari malformation), symptoms usually begin between ages 25 and 40.
Symptoms may affect different parts of the body, including the back, shoulders, arms, and legs. Some people notice that coughing or straining makes their symptoms worse, though these actions don’t cause the condition.
Common symptoms include:
- Muscle weakness and wasting
- Decreased reflexes
- Reduced sensitivity to pain and temperature
- Headaches
- Stiffness in back, shoulders, arms and legs
- Pain in the neck, arms and back
- Sideways curvature of the spine (scoliosis)
Medical Attention Guidelines
Visit a healthcare provider if you experience any symptoms associated with syringomyelia. Don’t delay seeking medical help.
If you have a history of spinal cord injury, be especially watchful for these symptoms. Syringomyelia can develop months or even years after a spinal injury.
Make sure to inform your healthcare provider about any previous spinal injuries when discussing your symptoms.
Causes
Syringomyelia develops when cerebrospinal fluid (CSF), which normally surrounds and protects the brain and spinal cord, collects inside the spinal cord itself. This collection forms a fluid-filled cyst called a syrinx.
Several conditions can trigger this abnormal fluid collection:
- Chiari Malformation: Brain tissue extends into the spinal canal, blocking normal CSF flow.
- Meningitis: Inflammation of the protective membranes around the brain and spinal cord.
- Spinal Cord Tumors: Can disrupt the natural circulation of CSF.
- Congenital Conditions: Such as tethered spinal cord, where tissue attachments limit spinal cord movement.
- Traumatic Injuries: Damage to the spinal cord that may cause symptoms to appear months or years after the initial injury.
The exact mechanisms behind syringomyelia remain somewhat unclear to medical researchers. What is known is that these conditions interfere with the normal flow and pressure of cerebrospinal fluid, creating the circumstances for syrinx formation.
Complications
Syringomyelia can progress in some individuals and cause serious issues. Meanwhile, others may experience no symptoms at all.
If a syrinx grows or damages spinal cord nerves, several complications may develop:
- Scoliosis – sideways curvature of the spine.
- Chronic pain due to spinal cord damage.
- Motor difficulties affecting walking. These include weakness in leg muscles and muscle stiffness.
- Paralysis in severe cases.
These complications vary widely among patients. They depend on the size and location of the syrinx.
