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Neurology (Expert Forum)
Possible Syringomyelia
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Possible Syringomyelia
by AlanaLee, Oct 24, 2006 12:00AM
Hello,
I am a 43 year old woman. My only health problem until recently has been Hashimoto's Thyroiditis which I was diagnosed with 5-7 years ago. I am on cytomel and synthroid.
For 6 months, I have had the following symptoms:
Constant numbness in feet, ankles, calves
Extreme discomfort in feet, legs, low back when walking
Some hand tingling/numbness
Cold feet
I have had the following tests:
Cervical, brain (with contrast) and lumbar MRI
EMG
Bloodwork
Evoked Potential
Chest XRay
Arterial Dopler Study
All tests were normal except for my lung xray which showed "pleural scarring" and my cervical MRI which showed a "prominent central canal." I am scheduled to have a lumbar puncture in early November.
I have had 14 car accidents in the last 15 years and my neurologist thinks the prominent central canal might be syringomyelia. He's not sure though, because of the hand symptoms. I've looked at the symptoms and they seem very different than mine. The neurologist said my brain MRI was normal, indicating that I do not have MS. My EMG and blood results were also normal, which he said indicates that I probably don't have ALS.
Can you please give me some idea of what I still might have and what tests I should consider? If you think it is probable that I have syringomyelia, can you please let me know what I can expect and what options are available to me?
THANKS IN ADVANCE FOR YOUR HELP!
Alana
I am a 43 year old woman. My only health problem until recently has been Hashimoto's Thyroiditis which I was diagnosed with 5-7 years ago. I am on cytomel and synthroid.
For 6 months, I have had the following symptoms:
Constant numbness in feet, ankles, calves
Extreme discomfort in feet, legs, low back when walking
Some hand tingling/numbness
Cold feet
I have had the following tests:
Cervical, brain (with contrast) and lumbar MRI
EMG
Bloodwork
Evoked Potential
Chest XRay
Arterial Dopler Study
All tests were normal except for my lung xray which showed "pleural scarring" and my cervical MRI which showed a "prominent central canal." I am scheduled to have a lumbar puncture in early November.
I have had 14 car accidents in the last 15 years and my neurologist thinks the prominent central canal might be syringomyelia. He's not sure though, because of the hand symptoms. I've looked at the symptoms and they seem very different than mine. The neurologist said my brain MRI was normal, indicating that I do not have MS. My EMG and blood results were also normal, which he said indicates that I probably don't have ALS.
Can you please give me some idea of what I still might have and what tests I should consider? If you think it is probable that I have syringomyelia, can you please let me know what I can expect and what options are available to me?
THANKS IN ADVANCE FOR YOUR HELP!
Alana
Doctor's Answer
by CCF-Neuro-M.D.-SH, Nov 06, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
A finding of 'prominent central canal' is often a normal finding. It is more likely to be normal if you have had an SSEP and an EMG that were also normal. The concerning thing about your history is the hashimoto's thyroiditis. This condition can be associated with odd neurologic symptoms and it responds dramatically to steroids. The condition is called Steroid responsive encephalopathy associated with Hashimoto’s thyroiditis (SREHT). Further diagnostic tests for this condition would include TSH, anti-thyroid antibody titers, and a SPECT scan of the brain-looking for areas of less blood flow.
To further investigate the possibility of syrinx I would suggest a CINE cerebro-spinal fluid flow study of the brain and Cervical spine.
I would also suggest a vascular ultrasound of the arteries and veins in your legs to evaluate for peripheral vascualr disease as the cause (intermittent claudication).
I hope this has been helpful.
A finding of 'prominent central canal' is often a normal finding. It is more likely to be normal if you have had an SSEP and an EMG that were also normal. The concerning thing about your history is the hashimoto's thyroiditis. This condition can be associated with odd neurologic symptoms and it responds dramatically to steroids. The condition is called Steroid responsive encephalopathy associated with Hashimoto’s thyroiditis (SREHT). Further diagnostic tests for this condition would include TSH, anti-thyroid antibody titers, and a SPECT scan of the brain-looking for areas of less blood flow.
To further investigate the possibility of syrinx I would suggest a CINE cerebro-spinal fluid flow study of the brain and Cervical spine.
I would also suggest a vascular ultrasound of the arteries and veins in your legs to evaluate for peripheral vascualr disease as the cause (intermittent claudication).
I hope this has been helpful.
