Syringomyelia is a tubular cavitation that develops within the spinal cord and which expands over many years. The most common site of origin is the lower cervical spinal cord.
Typical time course: onset during young adulthood, then progressing over 15 to 25 years
Neurologic involvement includes loss of anterior horn cells and disruption of the spinothalamic pathways.
The neurologic involvement is usually unilateral but may be bilateral.
Clinical features:
(1) aching and/or burning pain in the shoulder-girdle and arm
(2) shawl-shaped sensory impairment over the back and front of the upper thorax affecting temperature sensation and reaction to pin-prick but sparing other senses
(3) muscle wasting with weakness and fasciculations that starts in the small muscles of the hand and then slowly progresses up the arm to involve the shoulder girdle
(4) loss of tendon reflexes in the distal upper extremity
where:
• The person may burn the hand and not notice any pain.
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