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syringomyelia
Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in pain, paralysis, weakness, and stiffness in the back, shoulders, and extremities. Syringomyelia may also cause a loss of the ability to feel extremes of hot or cold, especially in the hands. The disorder generally leads to a cape-like loss of pain and temperature sensation along the back and arms. Each patient experiences a different combination of symptoms. These symptoms typically vary depending on the extent and, often more critically, to the location of the syrinx within the spinal cord.
Syringomyelia has a prevalence estimated at 8.4 cases per 100,000 people,〔Brewis M, Poskanzer DC, Rolland C, et al., "Neurological disease in an English city". ''Acta Neurologica Scand Suppl'' 24:1--89, 1966.〕 with symptoms usually beginning in young adulthood. Signs of the disorder tend to develop slowly, although sudden onset may occur with coughing, straining, or myelopathy.
== Signs and symptoms ==
Syringomyelia causes a wide variety of neuropathic symptoms due to damage of the spinal cord. Patients may experience severe chronic pain, abnormal sensations and loss of sensation particularly in the hands. Some patients experience paralysis or paresis temporarily or permanently. A syrinx may also cause disruptions in the parasympathetic and sympathetic nervous systems, leading to abnormal body temperature or sweating, bowel control issues, or other problems. If the syrinx is higher up in the spinal cord or affecting the brainstem as in syringobulbia, vocal cord paralysis, ipsilateral tongue wasting, trigeminal nerve sensory loss, and other signs may occur.〔Greenberg, David A, et al.: ''Clinical Neurology''. 5th ed. Feb 9, 2002.〕 Rarely, bladder stones can occur in the onset of weakness in the lower extremities.〔Nishida, Takayasu, et al. ("A large bladder stone caused by syringomyelia" ). ''Japanese Journal of Clinical Urology'', Vol.60, No. 6, pp 413-415, 2006. ISSN:0385-2393.〕
Classically, syringomyelia spares the dorsal column/medial lemniscus of the spinal cord, leaving pressure, vibration, touch and proprioception intact in the upper extremities. Neuropathic arthropathy, also known as a Charcot joint, can occur, particularly in the shoulders, in patients with syringomyelia. The loss of sensory fibers to the joint is theorized to lead to damage of the joint over time.〔("Neuropathic Arthropathy of the Shoulder (Charcot Shoulder): Clinical Commentary" ) Medscape. Accessed 9 January 2011.〕
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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