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 - 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?
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
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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