Unmasking the Mystery of A Hidden Syrinx: Case Report of Progressive Paralysis in A 20-Year-Old Male with Intact Pain and Temperature Sensations
DOI:
https://doi.org/10.51985/JBUMDC2023191Keywords:
MRI Scan, Syringomyelia, Syrinx in Spinal Cord.Abstract
Syringomyelia is a progressive neurological disorder in which a fluid-filled cyst known as syrinx forms within the spinal
cord. The case of a 20-year of adult is presented with lower limb stiffness and difficulty in walking for last 3 years. For
the last 1 year, he also developed stiffness of upper limbs. Upon examination, he had a spastic gait with no ataxia. There
was muscle wasting of both upper and lower limbs, with fasciculation. Tone was increased with reduced power and
hyperreflexia bilaterally in all four limbs with positive ankle clonus and upgoing plantars bilaterally. Sensory system,
cerebellum and higher motor functions were intact. MRI scan revealed an abnormal intramedullary multifocal T2WI hyper
intense signal in cervical and thoracic spinal cord consistent with syrinx and he was diagnosed with Syringomyelia. This
case is an uncommon presentation of Syringomyelia presenting with predominantly upper motor neuron lesion without
sensory involvement
References
Kim J, Kim CH, Jahng TA, Chung CK. Clinical course of
incidental syringomyelia without predisposing pathologies.
J Clin Neurosci. 2012;19(5):665-8. doi: 10.1016/j. jocn.
07.050.
Sixt C, Riether F, Will BE, Tatagiba MS, Roser F. Evaluation
of quality of life parameters in patients who have
syringomyelia. J Clin Neurosci. 2009;16(12):1599-603. doi:
1016/j.jocn.2009.04.019.
Lucchetta M, Cagnin A, Calderone M, Manara R, Rotilio A,
Briani C. Syringomyelia associated with Chiari I malformation.
Neurol Sci. 2009;30(6):525-6. doi: 10.1007/s10072-009-0133-
Nacir B, Arslan Cebeci S, Cetinkaya E, Karagoz A, Erdem
HR. Neuropathic arthropathy progressing with multiple joint
involvement in the upper extremity due to syringomyelia and
type I Arnold-Chiari malformation. Rheumatol Int. 2010;30(7)
:979-83. doi: 10.1007/s00296-009-1013-5.
Nakanishi K, Uchiyama T, Nakano N, Fukawa N, Yamada
K, Yabuuchi T, Kato A. Spinal syringomyelia following
subarachnoid hemorrhage. J Clin Neurosci. 2012 ;19(4):594-
doi: 10.1016/j.jocn.2011.07.035.
Wu J, Ji S, Niu P, Zhang B, Shao D, Li Y, et al. Knowledge
mapping of syringomyelia from 2003 to 2022: A bibliometric
analysis. J Clin Neurosci. 2023;110:63-70. doi: 10.1016/
j.jocn.2023.01.004.
Holste KG, Muraszko KM, Maher CO. Epidemiology of
Chiari I Malformation and Syringomyelia. Neurosurg Clin N
Am. 2023;34(1):9-15. doi: 10.1016/j.nec.2022.08.001.
Spennato P, Vitulli F, Tafuto R, Imperato A, Mirone G, Cinalli
G. Fourth ventricle to spinal subarachnoid space stenting in
pediatric patients with refractory syringomyelia: case series
and systematic review. Neurosurg Rev. 2023;46(1):67. doi:
1007/s10143-023-01972-y.
Sato S, Kakizaki T, Kondo K, Kanno C, Maeda Y, Ando R,
et al. Arnold Chiari malformation classified as Chiari 1.5
malformation in a Japanese black calf. J Vet Med Sci. 2023.
doi: 10.1292/jvms.22-0463.
Hersh AM, Lubelski D, Theodore N, Sciubba DM, Jallo G,
Shimony N. Approaches to Incidental Intradural Tumors of
the Spine in the Pediatric Population. Pediatr Neurosurg.
doi: 10.1159/000530286.
Lu C, Guan J, Ding C, Wang X, Wang Z, Chen Z, et al. Posttraumatic syringomyelia resolution following surgical
treatment: the moniliform syrinx with a better prognosis. Acta
Neurol Belg. 2023. doi: 10.1007/s13760-023-02233-x.
Osama M, Yaqoob F. Cervical syringomyelia; conservative
physical therapy management of a patient: a case report.
Professional Med J. 2017;24(4):627-632. DOI: 10.17957/
TPMJ/17.3817.
Butt B, Zunair SA, Rehman A, Latif A, Awan NR, Anwar K,
et al. Post-Traumatic Syringomyelia: A Case Series. Pak. J.
of Neurol. Surg. 2021; 25(4): 569-578. DOI:10.36552/ pjns.
v25i4.626.
Ihsanullah, Khanzada K, Alam M, Hameedullah. Surgical
Outcome of Chiari Malformation Type One in Adults. Pak.
J. of Neurol. Surg. 2019; 23(1): 14-18.
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Copyright (c) 2023 Muhammad Sohail Ajmal Ghoauri, Nauman Ismat Butt, Mutahra Khaliq, Muhammad Bilal Rasheed, Muhammad Umair Javed, Dur-e- Sabeh
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