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Syringomyelia presenting as shoulder dysfunction.

G L Singer1, J C Brust, Y B Challenor

  • 1Department of Physical Medicine and Rehabilitation, Columbia University College of Physicians and Surgeons, New York, NY.

Archives of Physical Medicine and Rehabilitation
|March 1, 1992
PubMed
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Syringomyelia, a condition causing spinal cord fluid-filled cavities, can present atypically in elderly patients. This case highlights the importance of considering syringomyelia even with unusual symptoms like unilateral sensory loss.

Area of Science:

  • Neurology
  • Orthopedics
  • Radiology

Background:

  • Syringomyelic neuroarthropathy typically affects younger individuals with bilateral symptoms and motor deficits.
  • Humeral subluxation is a rare complication of syringomyelia.

Observation:

  • An elderly woman presented with unilateral humeral subluxation and sensory loss, but largely preserved motor function.
  • Magnetic resonance imaging revealed a cervical syrinx, a fluid-filled cavity in the spinal cord.
  • Electrodiagnostic studies indicated a concurrent compressive brachial plexopathy.

Findings:

  • The patient's advanced age, unilateral sensory findings, and intact motor function were atypical for syringomyelia.
  • The combination of a cervical syrinx and brachial plexopathy led to the humeral subluxation.

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Implications:

  • This case suggests that syringomyelia may be underdiagnosed in elderly patients with atypical neurological presentations.
  • Clinicians should consider syringomyelia in the differential diagnosis of shoulder instability, even in older adults with unusual symptoms.
  • Advanced imaging and electrodiagnostic studies are crucial for diagnosing complex cases of syringomyelia.