Syrinx of cervicle spinal cord

[Carol]

I have been having left sided pain from neck,shoulders,back and leg for guite awhile.Before this I have had neck and shoulder problems since 95.My MRI showed slightly prominent central canal vs small syrinx at C7 level.My Doctors do not believe this is causing my pain but everything else has been ruled.Now he is saying I may have Fibromygia.Your help would be greatly appreciated. Thanks Carol

[CCF Neuro[P] MD, RPS]

Dear Carol:

Sorry about your pain.  A syrinx in the position you describe would give you paresthesias in a distribution of neck, shoulder and surrounding back in sort of a cape-like distribution.  But your leg would be spared.  I am not sure what is meant by a central canal.  Usually the differential is between syrinx and dysraphism of the spinal cord.  A dysraphism might give you the symptoms you describe.  The spinal cord does not have a central canal, so I am at a loss to give you a reason for your pain.  If what is being described as a central canal is whatever (?) and the possibility of a synrinx causing leg pain is not possible, then I would think the pain your experiencing is from another source.  Whether that be fibromyalgia or not is hard to know from what you have told me.

Sorry, that I'm not much help.

Sincerely,

CCF Neuro MD

[CAROL AGAIN]

I did leave out one word but I'm not sure if it would make differance.MRI reads,Findings consistent with either slightly prominent central canal dilatation vs small syrinx of the cervical spinal cord at C7 level.So you don't believe my leg pain is from syrinx? So could something pressing on spinal cord cause this type of pain?It's just very wierd being just left side of body.Thanks so much for your help,CAROL

[Ana]

When my daughter was diagnosed (age 9) with syringiohydromyelia (syrinx), I understood that cerebrospinal fluid pressure had built up in the brain, forcing fluid thru the obyx (obex?) where it collected in a cyst (sryinx) in the center of her spinal cord.  Ordinarily, this passageway doesn't get used, one MD explained it as a kind of failsafe device in the human body so that when cerebrospinal fluid pressure builds up, the fluid has a place to go.  Perhaps this is the "inner canal" that Carol referred to, that the responding MD didn't understand.

My daughter is monitored with MRI every 6 months.  If the syrinx enlarges or causes probs., shunt seems the treatment of choice, either to abdomen or into spinal canal.  

Duke investigating family connection.  Anecdotal: my aunt was diagnosed with Multiple Sclerosis and eventually died of complications.  MS, I hear, is one of the common misdiagnoses of syringio...  Her father, my grandfather, got some never-diagnosed neurological condition that apparently resulted in progressive paralysis.  

Syringiohydromyelia is often associated with Arnold Chiari (II, I belive).  

MDs in San Antonio (TExas) patch the dura and plug the obex for Chiari.  MD in Austin doesn't plug obex, does patch dura.  Bruce in Dallas amputates the protruding tonsils.  

There is a Syringiohydromyelia association in Texas.  Found it on the web. ASAP, P. O. Box 1586, Longview, TX  75606-1586.  1-800-ASAP-282, the SM hotline provided by Bobby Jones Open, leave message on machine with telephone number, name, address, and message about your concern.  I was contacted by a local woman whose son had the condition and she gave me lots of information.  

[Melissa]

Carol, perhaps if the doctor stops back in, he can address the condition called "Syringomyelia" (I believe this is what Ana was also mentioning; although I hadn't seen it spelled that way before.)

My brother began with a syrinx in his spinal cord, and was diagnosed with Syringomyelia.  Maybe if the doctor stops back in, he can advise you how prevalent this is in instances of syrinx's within the spinal cord?   I don't know a great deal about Syringomyelia, but I know that it causes a great deal of pain and frustration for my brother.  (He's only 34!)

I hope you find answers soon Carol !!

[Carol]

Does anyone know if you have syrinx in spinal cord,Does that mean you have syringomylia? Please HELP,I need to know if this is what I'm dealing with. CAROL

[CCF Neuro[P] MD, RPS]

Dear Carol:

I do not believe the small syrinx is causing the leg pain.  It is too small and in the wrong place.

Sincerely,

CCF Neuro MD

[CCF Neuro[P] MD, RPS]

Dear Carol:

A Syringomyelia is a generic term for a fluid-filled cavity within the substance of the spinal cord.  The cavity or syrinx, is centraly placed in the gray matter.  

Since the MRI did not indicate a Chiari malformation I would bet that your syrinx is congenital.  Again, since it is small, it is very doubtful that it is causing your leg symptoms.

CCF Neuro MD

[Beth to Neuro CCF(P)MD,RPS and Carol]

Arnold Chiari Malformation often is not mentioned on MRI films, unless it is written in the orders.  It is best to have them reviewed again for ACM.  That could be the source of leg pain.  Carol, there are 4 types of ACM, and your case sounds like type one.

[Merry Carole]

My brother had a brain tumor removed when he was 9 years old which left him with an occipital defect.  At age 50 he developed obstructive hydrocephalus and had a V-P Shunt put in. He now is 71 years old and the shunt is no longer functioning. On prvevious CATT Scans they noted a Syrinx. He has had increasing difficulty swallowing, he now is on a liquid diet only, he coughs continually when swallowing. He has discomfort in the back of his neck. Is this related to the syrinx? And progression of symptoms can be expected? Prognosis ? He is a nursing home resident and comfort is our main goal. Would appreciate any information. I see this web site is connected with Cleveland and the Neurosurgeon who performed his orginal craniotomy in the 1930's in Buffalo, New York then went on to Cleveland - Dr. Hanby.

[CCF Neuro[P] MD, RPS]

Dear Merry Carole:

Only a very large synrix would cause motor problems such as swallowing.  It is more likely something to due with his VP shunt malfunction and creating increased ICP or some other neurological problem. I would have your father see a neurologist and try and sort out this problem.

Sincerely,

CCF Neuro MD

[Merry Carole]

Thank you for your prompt answer to my comment/question.  He has been seen recently by a Neurologist. He agrees with me that there is not alot of case studies out there on adults. He feels that the progression we will see is increased lethargy eventually leading to a comatose state this being r/t the malfunctioning of the shunt. He feels that the increased swallowing difficulty may be related to small strokes that would not show on a CATT Scan. What are your feelings on this. Also both the doctor and I agree that my brother is too high a risk to have another shunt put in and that if he survived that proceedure we would not see much improvement. Thank you,

[CCF Neuro[P] MD, RPS]

Dear Merry Carole:

Since your neurologist agrees with your assessment, I will allow you two to talk about your brothers case.  I think that we physicians like our patients to talk to us.

Sincerely,

CCF Neuro MD

[angie]

In August, 1998 my husband fell approx. 15-20 feet from the top of a tankard truck into a rock lined ditch, landing on his lower back and side.  He has been to several doctors since that time.  He has been diagnosed with a syrinx in the lower lumbar (I'm not sure of exact disc location).  He experiences severe pain, including harsh spasms that run the length of his back.  He has severe pain and burning down his right leg.  The outside portion of his right foot is numb with burning if anything touches it (He says he can't feel the touch only the pressure).  His treating neurologist has also discovered that he has lost significant muscle in his right leg.  More recently he has been getting flashing lights in his vision (similar to migraine auras). He also has tingling in his hands.  The reason I'm writing is because we have one diagnosis of a small syrinx (MRI was performed in late 1998), however, we also have a diagnosis of pulled, ripped, and torn nerves in the lower half of his body.  We are confused by the conflicting diagnosis and what treatment he needs to receive in order to hopefully get better.  My husband is only 29 years old!  What are our options?  Where should we turn to now?  He is currently medicated (Lortab, Flexeril, and Neurontin).  He is not the type of man who likes to be continually drugged, however, he has been since 1998. We would like to find someone who can help us.  Any response would be greatly appreciated.

[CCF Neuro[P] MD, RPS]

Dear Angie:

I am reluctant to answer your posting.  The reason is as always, legal.  I am assuming that your posting is purely for educational reasons but in the past people have used forums such as this for legal reasons, which is entirely unethical.  Without an examination I can't tell you anything exactly.  Syrinx give a characteristic pattern of sensory changes.  Your husband, by description does not.  I wouldn't think a small syrinx could give a non-dermatome distribution of sensory changes as your husband, by description, has.

CCF Neuro MD

[Kelly Proctor]

On July 7, 2001 I was doing a patient transfer at work when I felt something in my shoulder blades give way.  I sought treatment, only to be told it was nothing but muscular and needed physical therapy if I did not improve and treat the pain with drugs.  
On August 22, 2001 I had pain shoot down my right arm, which had the same feeling as if you were to hit your funny bone.  The pain grew intense.  I ended up out in ER for a pain shot.  The following day (24 hours later), the other arm was affected, hands started to curl.  Again another trip to ER.  MRI ordered and performed 3 days later.
Findings - C6-7 level small central and left-sided broad based disc hernation. Tiny central cord T2 signal hyperintensity from C6-7 up to T1-2 disc level present consistent with tiny cord syrinx or even slightly dilated central canal.

Pain did go through my legs for short periods of time.  
Doctor that I saw in the ER 8/27 stated these problems with my back are not causing my back pain.

Treatments being discussed - physical therapy, neurologist, follow up examination.

[tymyster]

A related discussion, hiccupps was started.

[connieporras]

A related discussion, looking for doctor in san antonio, tx that has treated syringomyelia was started.