[Late syringomyelic syndromes in paraplegics]

Area of Science:

• Neurology
• Neurosurgery
• Spinal Cord Injury

Background:

• Syringomyelia is a rare condition characterized by a fluid-filled cyst within the spinal cord.
• Late onset syringomyelia in paraplegics is a distinct clinical entity requiring specific diagnostic considerations.
• Understanding the pathogenesis and clinical course is crucial for managing paraplegic patients with this condition.

Observation:

• A review of 35 literature cases and 12 personal cases of late onset syringomyelia in paraplegics was conducted.
• Initial pain was present in just over half of the cases, with insidious onset and sensory disturbances leading to delayed recognition.
• The condition can mimic idiopathic syringomyelia with arthropathy, but may also involve impaired touch and proprioception.

Findings:

• Neurosurgical treatment targeting the fluid-filled cavity did not appear to significantly alter the spontaneous progression of the condition.
• In 5 reviewed cases, the underlying paraplegia was not attributed to traumatic injury.
• The study discusses potential underlying mechanisms contributing to late onset syringomyelia in paraplegics.

Implications:

• Delayed diagnosis of late onset syringomyelia in paraplegics is common due to subtle, insidious symptoms.
• Current neurosurgical approaches may not effectively modify the natural history of this condition.
• Further research into the etiology and pathophysiology of late onset syringomyelia in paraplegics is warranted to improve patient outcomes.