He reported no difficulty adapting to the orthotics. I met Carmelo at the shopping center last week. He told me that he experienced a slight cephalgia three times in the last six months, but each time it lasted less that two hours. Syringomyelia is a relatively rare disorder, generally appearing in young adults and probably developmental in origin. To answer Dr. Morgan, the congenital forms are often associated with the Arnold-Chiari Malformation or other neurologic defects, such as encephalocele or myelomenigocele.
Macroscopic examination reveals swelling and thickening of the meninges at the site of involvement.
The formation suggests that the gliosis precedes the cavitation. The fibers of pain and temperature which cross the cord and pass up the lateral spinothalamic tract are interrupted, as well the fibers of touch of the anterior spinothalamic tract, but the posterior columns transducing light touch and vibration sense are unaffected - resulting in a 'dissociated' sensory loss in the early stages of the condition. As the cyst becomes larger, pressure on the long tracts, such as the pyramidal tract, demonstrate signs of upper motor neurone lesions in the lower extremities. Over the course of many years, the progressive neurologic deficit and disability ensue. The anesthesia predisposes these unfortunate people with trophic ulceration of the hands and neuropathic arthropathy.