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[Multiple sclerosis with syringomyelia--case report]

K Deguchi1, H Takeuchi, A Yamada

  • 1Third Department of Internal Medicine, Kagawa Medical School, Japan.

No to Shinkei = Brain and Nerve
|January 1, 1994
PubMed
Summary
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Multiple sclerosis (MS) can lead to cervical syrinx formation, impacting neurological function. Functional recovery in MS patients with syringomyelia depends more on demyelination severity than the syrinx itself.

Area of Science:

  • Neurology
  • Neuroimaging
  • Clinical Neuroscience

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
  • Syringomyelia, the formation of a syrinx within the spinal cord, can occur secondary to various spinal cord pathologies.
  • The interplay between MS, myelopathy, and syrinx formation presents diagnostic and prognostic challenges.

Observation:

  • A 32-year-old woman with a history of recurrent neurological episodes (myelopathy, optic neuritis, cerebellar ataxia) was diagnosed with MS based on brain MRI findings.
  • Initial spinal MRI showed no abnormalities, but a later MRI revealed cervical syrinx formation (C2-C6) coinciding with progressive paraparesis and sensory deficits.
  • Despite syrinx reduction over four months, significant motor and sensory impairments persisted, indicating limited functional recovery.

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Findings:

  • The case highlights the potential for syrinx formation in the cervical spinal cord in patients with multiple sclerosis and recurrent myelopathy.
  • Neurological examination revealed complex deficits including nystagmus, finger weakness, paraparesis, spasticity, and sensory disturbances.
  • Spinal MRI confirmed syrinx formation at C2-C6, which partially resolved but did not lead to substantial functional recovery.

Implications:

  • This case suggests that the prognosis for multiple sclerosis patients who develop syringomyelia following myelopathy may not always be favorable.
  • Functional recovery in MS with syringomyelia appears to be primarily influenced by the extent of demyelination and gliosis caused by MS, rather than the syrinx presence alone.
  • Further research is needed to understand the mechanisms underlying syrinx formation in MS and its impact on long-term outcomes.