Last updated: April 4, 2022

Summarytoggle arrow icon

Syringomyelia is a condition in which an abnormal fluid-filled cavity, or syrinx, develops within the central canal of the spinal cord. The syrinx is a result of disrupted CSF drainage from the central canal, commonly caused by a Chiari malformation or previous trauma to the cervical or thoracic spine. In select cases, the syrinx may occur in the brainstem, and is then referred to as syringobulbia. The syrinx initially compresses and permanently damages crossing fibers of the spinothalamic tract. Further expansion may affect other tracts of the spinal cord. Symptoms include dissociated sensory loss, presenting as a cape-like distribution of decreased sensitivity to pain and temperature, and flaccid atrophic paralysis in the upper extremities. MRI is the diagnostic modality of choice. Treatment depends on clinical features and associated findings. Symptomatic treatment commonly suffices in stable courses of disease, while patients with progressive neurological deterioration require surgical decompression.

Epidemiologytoggle arrow icon

  • Sex: > , especially in traumatic spinal cord injury-related (SCI-related) syringomyelia
  • Age range: 30–40 years (SCI-related syringomyelia may occur in all age groups)

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

Pathophysiologytoggle arrow icon

Syringomyelia is an abnormal fluid-filled dilation of the central canal of the spinal cord occurring as a result of impaired CSF flow.

Clinical featurestoggle arrow icon

Diagnosticstoggle arrow icon

Differential diagnosestoggle arrow icon

The differential diagnoses listed here are not exhaustive.

Treatmenttoggle arrow icon

Conservative therapy is usually sufficient, but definitive surgical treatment is recommended for patients with progressive neurological symptoms.

Surgical treatment

Supportive therapy

Referencestoggle arrow icon

  1. Eisen A. Disorders affecting the spinal cord. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. Last updated: May 26, 2015. Accessed: November 28, 2017.
  2. Syringomyelia Information Page. Updated: March 1, 2017. Accessed: March 1, 2017.
  3. Gilman S. Joint position sense and vibration sense: anatomical organisation and assessment. Journal of Neurology, Neurosurgery & Psychiatry. 2002; 73: p.473-477.doi: 10.1136/jnnp.73.5.473 . | Open in Read by QxMD
  4. Backonja M, Glanzman RL. Gabapentin dosing for neuropathic pain: evidence from randomized, placebo-controlled clinical trials. Clin Ther. 2003; 25 (1): p.81-104.

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