[The pattern of neurological deterioration and the mechanism of neurological deficit in syringomyelia].
Sixty-five cases of syringomyelia were evaluated. The cases were classified into two groups: group 1 (56 cases) was patients who presented with hind-brain related syringomyelia and group 2 (9 cases) was patients who presented with primary spinal syringomyelia. Group 1 was further divided into two subgroups, group 1a and group 1b: group 1a (46 cases) consisted of patients with hind-brain related syringomyelia without basal arachnoiditis and group 1b (10 cases) consisted of patients with hind-brain related syringomyelia with basal arachnoiditis. The most common initial symptom of group 1a patients was abnormal motor function of an upper limb (14 cases), followed by pain in an upper limb (12 cases), and dissociated sensory loss (10 cases). In group 1b, motor symptoms of an upper limb were also the most common initial symptom, again followed by pain in an upper limb. Paraplegia was the most common initial symptom in group 2. About 80% of patients in groups 1a and 1b had both sensory and motor deficits at the time of examination and the majority of group 1b patients also had brain stem signs and/or pain. Brain stem signs were not commonly seen in group 1a patients, however. The neurologic deficits of group 1b patients were generally more severe than those of group 1a patients. Most group 2 patients also had sensory and motor deficits of both lower limbs. The progression of neurological deficits in groups 1a and 1b was classified into four stages.(ABSTRACT TRUNCATED AT 250 WORDS)
Abe
T
T
Department of Neurosurgery, Jikei University School of Medicine.
Tashibu
K
K
Onoue
H
H
Watanabe
R
R
Nakamura
N
N
D000293:Adolescent; D000328:Adult; D001100:Arachnoiditis / Q000150:complications; D002648:Child; D006801:Humans; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology*; D012678:Sensation Disorders / Q000209:etiology*; D013116:Spinal Cord / Q000473:pathology; D013595:Syringomyelia / Q000150:complications* / Q000473:pathology