Syringomyelia - CRASH! Medical Review Series

[@woloabel]

September 25, 2022. Neurology: Spinal Cord Injury/Lesions: Syringomyelia (Syrinx Compression of Spinothalamic Tract). Pathophysiology is Compression of the Spinothalamic Tract by a Syrinx (Cyst in the Central Canal) due to Varous Possible Causes. SSx: 1) Anaesthia to Shoulder/Back Region, 2) Temperature Agnosia to the Affected Region. 3) Vibratory Sensation Intact (DCML is Unaffected), 4) Motor Function is Present (CS is Unaffected). Px: 1) Clinical Presentation follows: 1) Loss of Pain Sensation in a Cape-Like Morphology, 2) Loss of Temperature Perception in the Aforementioned Manner and 3) Symptomatology Limited to Cervical and Upper Thorax, 4) Upper Extremity Deep Tendon Reflexes (DTRs) are Diminished or Absent. Aetiology: 1) Post Trauma, 2) Neoplasm, 3) Arnold-Chiari Malformation (Cerebellum Herniation), 4) Meningitis (Complication of Infection).DDx (Distal Anesthesia/Paresthesia: 1) Subacute Combined Degeneration (SCD) involves the DCML and has Proprioception Deficiency (also Hyperreflexia, Babinski Sign Positive [Plantar Flexion]), 2) Diabetic Neuropathy (Normal MRI and have an Intact ST Tract) has Sensation of Pain and Temperature, 3) Multiple Sclerosis (MS) has a Distinct MRI Morphology (CNS Plaques) and Presents with Waxing/Waning Symptomatology, 4) Neoplasm (Tumor). Dx: Magnetic Resonance Imaging (MRI) to the Cervical Spine Diagnosis, otherwise Cervical MRI. T2 Weighted MRI will show a distinct Morphology of a Syrinx. Tx: Neurosurgical Referral for Surgery (Decompression of The Spinal Cord on Syrinx Location {Syringotomy]). Outstanding!

[@corytruitt2047]

I suffer syringomyelia. I appreciate your presentation. Much more comprehensive, up to date, and IMHO functionally correct, than the Kaplan review. I wish more docs were so literate on the subject. However, the cape-like distribution of "loss of pain and temperature" notations could be misleading. Make no mistake- syringomyelia can be very painful condition.

[@manudasmd]

Cory Truitt yes. truth is people suffering from the disease are more informed and knowledgeable about the disease than most of the doctors about that particular disease especially the well educated patients, Coz they do some extensive research on the subject + their experiences

[@bhupatbhaikarmur7038]

​@@manudasmdyas

[@fuadmohamed6080]

its so useful lectures ,,dr paul bolin i like the way you make the knowledge for easy and concise .i hope you continue the pediatric lectures

[@AJohnson0325]

Thank you! That was a much better review than my pediatric anesthesia book. By surgical decompression I assume you mean laminectomy.

[@علياعتدالنعمةالجابري]

your lectures is the best presentation that i have ever attend >> thank you so much and god bless you .

[@nadeemkhalid205]

thanks, much better than Kaplan reviews.

[@carolyncaton6529]

I have syringomyelia as a result of a very terrible incident from low b12 plus bactrim. Mine are T7-T9 and T10-L1. A cervical mri would have been no help at all in diagnosing mine.

[@AJohnson0325]

true, but if you were having symptoms in other places then a doctor hopefully would have picked that up during a history or physical which they then use to guide tests if necessary

[@DrDinooshDeLivera]

Thank you! Really well-done!

[@nadeemkhalid205]

how can I access to your full medical review series?

[@patjuskiw2418]

No pain, what do you mean. Syringomyelia=pain

[@Rerevise101]

There will be loss of pain

[@valarielewis205]

If it is a small syrinx or two, would it be possible for an increase in pain in these regions instead because it can still get through, just more slowly?

[@stephaniew4168]

What if you have a syrinx and a known B12issue? How do you know which one is causing which symptoms?

[@macdaddy2727]

Is there any possible way that a syrinx 3mm in size will cause index finger extreme pain (3yrs)

[@dr.varshad.l3944]

Thank you 😊

[@anastasiaaa4094]

Thank you... very well explained :)

[@nimraaslam7715]

Thank you so much!

[@samangulnovruzova1177]

Thank you a lot

[@bnelsonosas]

you were formally correct corticospinal is laterally and anteriorly not posteriorly.

[@manudasmd]

Estrella lili N. he said after decussation they move posteriorly which is correct. anterior CST are uncrossed

[@Muuip]

Actually it is more like a pain in the BACK instead of a pain in the butt... not sure why you classified it that way!!?? ;) Very helpful presentation though, many thanks.

[@khanssahassan8756]

thanks alot