Tuesday, 14 September 2010

MRCP revision battle 11.3: Syringomyelia and Syringobulbia

Syringomyelia and syringobulbia have always confused me, partly because for some reason I even have problems pronouncing their names!  However, in terms of MRCP there isn't too much you need to know...

Syringomyelia is a cyst/cavity forming in or close to the central canal of the spinal cord.

The cause may be anything that is hindering CSF circulation, but the classical cause is an Arnold Chiari malformation (=condition where the cerebellum herniates through the foramen magnum.)

The essential features are:
  • wasting and weakness of muscles of the hands (possibly 'claw hand')
  • loss of pain and temperature sensation in hands

Other possible signs/symptoms are varied and include Horner's syndrome, eye movement abnormalities and UMN signs in the legs.

Treatment is surgery.

If the cavity/cyst extends from the cord into the brain stem it is known as syringobulbia and causes bulbar palsy type symptoms, facial pain and dizziness.

After that neurology binge onto a slightly lighter topic, Kallmans...