What Is Syringomyelia?

Syringomyelia is a long-term condition that causes fluid-filled cysts, which doctors call “syrinx,” to form inside the spinal cord.

Some people don’t have symptoms, and might not even know they have it. But if it’s a severe case, it causes problems that need to be treated.

Syringomyelia is most common in adults aged 20 to 40, but it can happen to people of all ages. Men are more likely to get it than women.

What Causes It?

You get this condition when the normal flow of cerebrospinal fluid, the fluid that protects the spinal cord and brain, is blocked. It enters the central canal of the spinal cord and can cause a cyst to form.

With syringomyelia, there are two main reasons this fluid can get blocked or rerouted: a birth defect or trauma.

It usually happens when there’s a problem with the baby’s brain development during pregnancy. A defect that doctors call a “Chiari I malformation” causes the lower part of the baby’s brain to push downward into his spinal canal. This blocks the normal flow of fluid between the spine and the brain, and a cyst forms. But not everyone with a Chiari I malformation develops this disorder.

Post-traumatic syringomyelia is when a cyst forms in a damaged part of the spinal cord. It may happen when there is:

  • Swelling of the covering of the spinal cord
  • Meningitis
  • Spinal cord injury
  • Spinal tumor
  • Tethered spinal cord

Sometimes, it happens for reasons doctors don’t understand. They call this “idiopathic syringomyelia.”

What Are the Symptoms?

Symptoms depend on the location and size of the cyst. Over time, if it grows wider and longer, it can damage the nerves in the center of the spinal cord. This can lead to chronic pain that is hard to treat.

Symptoms usually develop slowly over many years. But they can appear suddenly after an accident, like a fall.

Other symptoms you may experience include:

  • Curving of the spine, called scoliosis
  • Changes in bowel and bladder function
  • Excessive sweating
  • Inability to feel hot and cold in the fingers, hands, arms, and upper chest
  • Muscle weakness, especially in the arms, hands, and shoulders
  • Feeling numbness, tingling, burning, or piercing
  • Pain in the neck, shoulders, and sometimes arms and hands
  • Paralysis (in severe cases)
  • Headaches
  • Swings in blood pressure levels
  • Twitches, or involuntary muscle contractions
  • Uncoordinated movements

If the cyst damages a nerve that controls the muscles in the eyes and face, you may get what doctors call Horner syndrome. It causes droopy eyelids, narrowing of the opening between the eyelids, reduced pupil size, and decreased sweating on the affected side of the face.

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How’s It Diagnosed?

Doctors use magnetic resonance imaging (MRI) scans of the brain and spine to see if you have syringomyelia. The MRI can show a cyst or other condition.

Sometimes, doctors discover you have this condition when doing an MRI for another health reason.

What’s the Treatment?

You probably won’t need any if you don’t have symptoms. But you should have regular checkups to watch for cyst growth and changes in signs and symptoms. Your doctor may tell you to avoid activities like heavy lifting that involve straining.

If you do have symptoms, he may recommend surgery to restore the normal flow of the cerebrospinal fluid.

The type of surgery you need depends on what caused your syringomyelia. For example, if the problem is due to a Chiari I malformation, your doctor might perform a procedure called posterior fossa decompression. This is when he’ll remove the bone at the back of your skull and spine. It creates more space for your brainstem and cerebellum -- the part of the brain that controls your movements and balance.

Talk to your doctor about the risks and benefits of surgery.

He might also prescribe medicine for pain or refer you to physical therapy.

WebMD Medical Reference Reviewed by Neil Lava, MD on March 05, 2019

Sources

SOURCES:

National Organization of Rare Disorders: “Syringomyelia.”

American Syringomyelia & Chiari Alliance Project: “Syringomyelia.” 

National Institute of Neurological Disorders and Stroke: “Syringomyelia Fact Sheet.”

Mayfield Brain & Spine: “Chiari I Malformation.”

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