Many are interested in syringomyelia - what it is and how this disease manifests itself. This is a lesion of the nervous system, which is characterized by a slow chronic course. With untimely or incorrectly carried out treatment, there can be a wide variety of complications that lead to paralysis or even death of the patient.
Disease feature
What is it, syringomyelia, it is necessary to know for all those who have this disease. It proceeds in a chronic form and is characterized by the formation of cavities in the spinal cord filled with fluid. As a result of this, the cyst grows, which then puts pressure on the vertebrae, as well as the nerve endings. All this leads to tissue damage, impaired posture and spinal deformity.
In addition, this negatively affects motor activity, as there is weakness of the limbs, stiffness of movements, pain in the back. Often there is one or more signs, and their combination can be very different.
The disease is completely incurable and goes into the chronic stage. Symptomatic or neuroprotective therapy is used to relieve symptoms. In especially severe cases, surgery is performed to remove excess fluid from the cyst.
The development of the disease proceeds very slowly, it all depends on the factor that triggered the pathological process, so several years can pass before the exacerbation. Sometimes the disease can affect the brain, and in this case, the pathological process can proceed rapidly and in a very complex form.
The main forms of the disease
It is important to know not only what it is, syringomyelia, but also what forms of this disease exist. There are several forms of the development of the disease, in particular, such as:
- anteropodic;
- bulbar;
- postnatal;
- mixed;
- vegetative trophic.
In addition, there may be true syringomyelia, which is a congenital disease, provoked by a malfunction of the spinal cord during the embryonic development of the child. The post-traumatic form is an acquired disease provoked by injuries.
Syringomyelia can be triggered by the development of malignant neoplasms, as well as compression of the nerve endings. The disease can be triggered by intervertebral hernias.
Provocative factors
Knowing what it is, syringomyelia, and what are the causes and symptoms, it is possible to recognize the course of the disease in a timely manner and conduct complex treatment to prevent the development of complications. The causes of the disease are associated with congenital defects of the glial tissue, which is represented by cells of the nervous system surrounding the neurons. These cells are involved in the transmission of nerve impulses.
With the occurrence of syringomyelia, there is an excessive growth of glial tissue in the brain and spinal cord of the thoracic and cervical spine. An early infectious disease or trauma can provoke a pathological process.
A feature of glial cells is that they are able to pass fluid. Therefore, fluid accumulates in the cavity, which gradually leads to an increase in their size. The formation of cavities provokes compression of adjacent nerve cells, their destruction and subsequent death.
The main symptoms
Syringomyelia of the spine for a long time can occur without obvious signs, which greatly complicates its diagnosis. Among the main symptoms, signs such as:
- violation of sensitivity in the limbs;
- decreased skin sensitivity;
- tremor of limbs;
- amyotrophy;
- deformation of the skull, spine, chest;
- poor regeneration of the skin.
Initially, there is a violation of sensitivity, as a result of which the skin loses its ability to feel pain and the effects of temperature. Depending on the degree of the course of the disease, some parts of the body may lose sensitivity.
With the subsequent development of symptoms, sensitivity disorders can go into a deeper form, and at the same time there is a loss of sensitivity in the muscles and joints. A characteristic sign is a sharp decrease in muscle volume, up to their atrophy and impaired mobility of the hands. In the affected area, trophic ulcers and vascular disorders often occur.
Syringomyelia is often accompanied by prolonged bouts of aching pain in the chest, neck, shoulder blades, shoulder joints and arms. One of the most common manifestations of the disease is osteoporosis.
Signs of syringobulbia
The presence of a cavity in the medulla oblongata is called syringobulbia. This disease differs from syringomyelia in the available symptoms and nature of the lesion. In this regard, the glossopharyngeal, sublingual and vagus nerves suffer. A similar pathology provokes symptoms such as:
- numbness of the palate and tongue;
- deterioration in taste;
- hoarseness of voice;
- hearing impairment.
The formation of cysts in the medulla oblongata can be observed in other parts of the spine. Among the complications of syringobulbia can be distinguished such as atrophy of tissues located in the face, and in some cases even respiratory arrest.
Diagnostics
Syringomyelia of the cervical and thoracic spine is quite difficult, so it is important to conduct timely diagnostics to determine the presence of the disease. Among the main diagnostic methods can be identified such as:
- Magnetic resonance imaging;
- X-ray examination;
- electromyography;
- otoneurological research.
Electromyography allows you to assess the degree of impairment of motor neurons through certain signals coming from the spinal cord. An otoneurological examination is performed in case of suspected syringobulbium and damage to the nerve fibers of the brain stem. In addition, it is advisable to consult a psychologist during the diagnosis.
Treatment feature
It is impossible to completely cure cervicothoracic syringomyelia. With the help of therapeutic and preventive methods, acute symptoms can be eliminated and the development of the pathological process stopped.
The peculiarity of conducting therapy largely depends on at what stage the disease is determined. At the initial stage of the course of the disease, when pathological reproduction of glial cells occurs in the tissues of the spinal cord, treatment is aimed at suppressing their growth. To do this, apply such techniques as:
- x-ray therapy;
- radioactive iodine treatment;
- drug therapy;
- physiotherapeutic techniques.
Surgical intervention is carried out only in exceptional cases with a rapidly progressive form of the disease. The operation does not completely get rid of the disease, therefore, it is carried out in the most extreme cases.
Drug treatment
Treatment of syringomyelia is carried out with the use of medications and is aimed at eliminating the main symptoms that cause discomfort. Neuroprotectors will help reduce the fluid content in the cavity and reduce pressure on surrounding tissues.
Painkillers and ganglion blockers will help get rid of dull or severe pain with cervical syringomyelia. The drug “Prozerin”, which can be combined with radon baths or UHF, will help normalize neuromuscular impulses. Such a procedure will only allow for some time to eliminate the discomfort, without affecting the course of the disease itself.
Surgical intervention
With syringomyelia of the cervical spine, surgery can be performed. The operation is prescribed in the presence of voids, a congenital violation of the outflow of cerebrospinal fluid from the brain. Surgically, you can eliminate the formed cysts, as well as correct existing violations of the structure of the spine.
In addition, cystic neoplasms can be drained to remove excess fluid. Pathology diagnosed in the initial stages is treated with x-ray or radioactive iodine. X-ray therapy makes it possible to prevent pathological growth of glial tissue. As a result of this, small cavities in the future will not grow and cause significant harm to health.
A feature of conducting therapy with radioactive iodine is that the substance used accumulates in the affected cells, and then they are irradiated from the inside, and as a result, the disease does not develop further. To avoid its excessive accumulation in the thyroid gland, you need to use Lugol solution in advance.
Disease complication
Complications of thoracic or cervical syringomyelia are characterized by the occurrence of a number of diseases of the internal organs. Often, concomitant diseases can be a malfunction of the internal organs, endocrine glands. Due to the deterioration in blood supply, oxygen starvation of the heart muscle is possible.
With secondary infection in the patient, the respiratory system and the genitourinary system can be involved in the pathological process. The danger of a disease in the area of the brain stem lies in the likelihood of bulbar paralysis, which leads to respiratory arrest.
Prognosis after treatment
Thoracic syringomyelia can occur even in young children, but they do not pay any attention to the disease. The disease is diagnosed mainly at the age of 20-40 years. It develops gradually, and periodic remissions are also possible. In some cases, sharp deterioration is observed, up to the appearance of a transverse lesion of the spinal cord, provoked by hemorrhages.
The prognosis for life is favorable, patients for a long time retain their ability to work, adapting to possible changes provoked by the disease.
Preventive actions
Prevention measures primarily relate to avoiding the danger of infectious diseases that can provoke the progression of the disease and lead to the development of sepsis. The patient is recommended to lead a healthy lifestyle, eat properly and fully, and regularly undergo examination and treatment by a neurologist.
In addition, it is important to prevent the progression of the disease, as well as to prevent the occurrence of injuries, burns and infection. All preventive measures are selected by the doctor strictly individually, depending on the condition of the patient.