2 yr. old w/ syrinx, spina bifida occult

Scans from 5/05 show my two year old has two small syrinxes C4-C7 and T3-T8 (2mm). He also has spina bifida occulta. Not sure if he has a tethered cord. I

[CCF-Neuro-M.D.-PW]

The flow of CSF in a non-linear way around the spinal cord produces a change in the signal used to produce the MRI image - so it shows up as an apparent 'abnormality' but is really just CSF flowing around that region. If 'prominent' the flow may be caused by a turbulence around an abnormal area but this is hard to prove unless a strucutral abnormality is present. It is hard for me to be specific without looking at the actual scans.

A 2mm syrinx is pretty small but it may not be the only abnormality present - for example, there may be adhesions or chronic arachnoisitis (inflammation of the lining of the spinal cord) realte to the methotrexate. This may be invisible on MRI also. Syrinxes are commonly due to trauma, tumor or a congenital abnormality. I'm not sure if your can be explained by the local tumor/chemo but in most cases they remain static. Perhaps a repeat scan every 6 months at least initially to make sure it i snot expanding. I am not an expert in this area, though so you should pursue an expert opinion. A thethered cord should be apparent on MRI also - perhaps a second opinion of the MRI would be a good idea. Try the eCleveland Clinic radiology consult site. I cannot seperate over the internet the cause of his leg problems - thethered cord, myelopathy, peripheral neuropathy, chronic arachnoisitis. An EMG and nerve conduction studies could help differentiate a peipheral neuropathy from chemo from a spinal cord problem.

Good luck