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  #1  
Old 03-07-2013
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Default What's the diagnosis?

32 year old woman has 5 month history of progressive weakness in her hands and arms. Physical exam reveals decreased ability to distinguish sharp from dull stimuli in both arms. Vibration sensation is normal. Fasciculations can be seen in the upper arms. Sensory and motor examination of the legs are unremarkable. Which of the following is the likely cause of her findings?

A. ALS
B. Acute inflammatory demylinating polyradiculoneuropathy
C. Lambert Eaton myasthenic syndrome
D. Syringomyelia
E. None above
F. B & C
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Old 03-07-2013
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Default my answer

D. Syringomyelia
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Old 03-07-2013
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i guess syringomyelia
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Old 03-07-2013
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Syringomyelia
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Old 03-07-2013
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Syringomyelia - Involvement of Spinothalamic tracts as they decussate in the white matter anterior/underneath the central canal of the spinal cord. Progressive disease can involve adjacent anterior horn cells giving rise to LMN lesion signs in the upper limbs.
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Old 03-07-2013
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Quote:
Originally Posted by ameerakhan View Post
Syringomyelia - Involvement of Spinothalamic tracts as they decussate in the white matter anterior/underneath the central canal of the spinal cord. Progressive disease can involve adjacent anterior horn cells giving rise to LMN lesion signs in the upper limbs.
isnt spinoth tract involvement suppose to cause loss of pain and tempr sensation but here there are no symptoms related to that and in syringomyelia the dorsal column is usually spared..so how does loss in sensation be a symptom of syringomyelia?
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Old 03-07-2013
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Originally Posted by med_ziva View Post
isnt spinoth tract involvement suppose to cause loss of pain and tempr sensation but here there are no symptoms related to that and in syringomyelia the dorsal column is usually spared..so how does loss in sensation be a symptom of syringomyelia?
The spinothalamic tract carries crude touch too.
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Old 03-08-2013
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syringomelia
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Old 03-09-2013
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Quote:
Originally Posted by Doctor Ali View Post
32 year old woman has 5 month history of progressive weakness in her hands and arms. Physical exam reveals decreased ability to distinguish sharp from dull stimuli in both arms. Vibration sensation is normal. Fasciculations can be seen in the upper arms. Sensory and motor examination of the legs are unremarkable. Which of the following is the likely cause of her findings?

A. ALS
B. Acute inflammatory demylinating polyradiculoneuropathy
C. Lambert Eaton myasthenic syndrome
D. Syringomyelia
E. None above
F. B & C
syringomyelia..If ALS i would expect some motor involvement in lower limbs.. Dorsal column intact makes it more likely...
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  #10  
Old 03-09-2013
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Correct Answer Correct answer is D

Syringmyelia - cyst/cavitation of central canal of the spinal cord forms. It's more common at the cervical level. It associated with congenital Chiari type 1 malfunction in which the inferior cerebellum becomes displaced downward. Cyst begins centrally and the axons of anterior white commissure of spinal cord is destroyed; resulting in segmental loss of pain and temperature. If the cavitation extends anterolaterally, it may destroy lower motor neurons - causing weakness and fasciculations.
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