Features of syringomyelia include all of the following, Except :
Correct Answer: Ascending weakness
Description: Answer is D (Ascending weakness): Ascending weakness is not a typical feature of syringomyelia Syringomyelia is characterized by bilateral, segmental, dissociative sensory loss with atrophy & weakness of small muscles of the hand. Syringomyelia Disease in which the central canal of the spinal cord becomes enlarged (Usually in the cervical or upper thoracic levels) Sensory Features (Early) Dissociative sensory losse (Loss of pain and temperature with preserved proprioception / touch) SegmentatQ (confined to a limited number of segments) Bilateral (since location is central) Motor Features (Late) Weakness and Atrophy typically of small muscles of the hand due to degeneration of motor neurons in the anterior horn of spinal cord. (Weakness if present is usually more marked in arms than in legs - central cord syndrome) Syringomyelia is a cavitatory expansion of central canal of spinal cord caused by chronic progressive destruction of it's grey & white matter.Q The most commonly involved regions are the 'Lower cervical' and 'upper thoracic'. Q Since the disease usually stas at the base of the posterior horns of the lower cervical spinal cord, it tends to involve the sensory fibres, which cross the midline to form the spinothalamic tract. As these fibres carry the sensations for temperature & pain, one of the earliest signs of disease is an inability to differentiate or appropriate 'Hot and Cold' sensations on the inner side of forearm and hand. Thermo-anaesthesia usually precedes the Analgesia while Touch sensitivity is usually preserved (This leads to Multiple burns and non healing ulcers over the hands and forearms) Also note that this paicular form of "sensory loss" to temperature & pain with sparing of touch, is described as 'Dissociate AnaesthesitiQ and is considered as the "True Hallmark of the disease"Q.
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