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Diseases & Conditions

Syringomyelia

What is Syringomyelia?

Syringomyelia (sear-IN-go-my-EEL-ya) is a disorder in which a cyst forms within the spinal cord. This cyst, called a syrinx, expands and elongates over time, destroying the center of the spinal cord. Since the spinal cord connects the brain to nerves in the extremities, this damage results in pain, weakness, and stiffness in the back, shoulders, arms, or legs. Other symptoms may include headaches and a loss of the ability to feel extremes of hot or cold, especially in the hands. Each patient experiences a different combination of symptoms. Magnetic resonance imaging (MRI) has significantly increased the number of syringomyelia cases diagnosed in the beginning stages of the disorder. Signs of the disorder tend to develop slowly, although sudden onset may occur with coughing or straining. If not treated surgically, syringomyelia often leads to progressive weakness in the arms and legs, loss of hand sensation, and chronic, severe pain. In most cases, the disorder is related to a congenital abnormality of the brain called a Chiari I malformation. This malformation occurs during the development of the fetus and causes the lower part of the cerebellum to protrude from its normal location in the back of the head into the cervical or neck portion of the spinal canal. Syringomyelia may occur as a complication of trauma, meningitis, hemorrhage, a tumor, or arachnoiditis. Symptoms may appear months or even years after the initial injury, starting with pain, weakness, and sensory impairment originating at the site of trauma. Some cases of syringomyelia are familial, although this is rare.

Is there any treatment?

Surgery is usually recommended for syringomyelia patients. Recurrence of syringomyelia after surgery may make additional operations necessary; these may not be completely successful over the long term.
In some patients it may be necessary to drain the syrinx, which can be accomplished using a catheter, drainage tubes, and valves.

In the absence of symptoms, syringomyelia is usually not treated. In addition, a physician may recommend not treating the condition in patients of advanced age or in cases where there is no progression of symptoms. Whether treated or not, many patients will be told to avoid activities that involve straining.

What is the prognosis?

Symptoms usually begin in young adulthood, with symptoms of one form usually beginning between the ages of 25 and 40.  Symptoms may worsen with straining or any activity that causes cerebrospinal fluid pressure to fluctuate. Some patients, however, may have long periods of stability. Surgery results in stabilization or modest improvement in symptoms for most patients. Delay in treatment may result in irreversible spinal cord injury.

What research is being done?

Investigators have found that as the heart beats, syrinx fluid is forced downward. This finding suggests a role for the cardiovascular system in syringomyelia.

Surgical techniques are also being refined by the neurosurgical research community. It is also important to understand the role of birth defects in the development of hindbrain malformations that can lead to syringomyelia. Dietary supplements of folic acid during pregnancy have already been found to reduce the number of cases of certain birth defects.

Diagnostic technology is another area for continued research. Diagnostic tests have improved greatly with the availability of new, non-toxic, contrast dyes. Patients can expect even better techniques to become available in the future.

Organizations

American Chronic Pain Association (ACPA)

P.O. Box 850
Rocklin, CA 95677-0850
Phone: 916.632.0922
Toll-free: 800.533.3231
Fax: 916.652.8190
Email: ACPA@pacbell.net
Website: www.theacpa.org

American Syringomyelia Alliance Project (ASAP)

P.O. Box 1586
Longview, TX 75606-1586
Phone: 903.236.7079
Toll-free: 800.ASAP.282 (272.7282)
Fax: 903.757.7456
Email: info@asap.org
Website: www.asap.org

Christopher and Dana Reeve Foundation

636 Morris Turnpike, Suite 3A
Short Hills, NJ 07078
Phone: 973.379.2690
Toll-free: 800.225.0292
Fax: 973.912.9433
Email: info@christopherreeve.org
Website: www.christopherreeve.org

March of Dimes

1275 Mamaroneck Avenue
White Plains, NY 10605
Phone: 914.997.4488
Toll-free: 888.MODIMES (663.4637)
Fax: 914.428.8203
Email: askus@marchofdimes.com
Website: www.marchofdimes.com

National Organization for Rare Disorders (NORD)

55 Kenosia Avenue
Danbury, CT 06810
Phone: 203.744.0100
Voice Mail: 800.999.NORD (6673)
Fax: 203.798.2291
Email: orphan@rarediseases.org
Website: www.rarediseases.org

National Spinal Cord Injury Association

4590 MacArthur Blvd. NW, Suite 250
Washington, DC   20007-426
Toll-free: 800.962.9629
Fax: 866.387.2196
Email: info@spinalcord.org
Website: www.spinalcord.org

Paralyzed Veterans of America (PVA)

801 18th Street, NW
Washington, DC 20006-3517
Phone: 202.USA.1300 (872.1300)
Toll-free: 800.424.8200
Fax: 202.785.4452
Email: info@pva.org
Website: www.pva.org

Spina Bifida Association of America

4590 MacArthur Blvd. NW, Suite 250
Washington, DC 20007-4266
Phone: 202.944.3285
Toll-free: 800.621.3141
Fax: 202.944.3295
Email: sbaa@sbaa.org
Website: www.spinabifidaassociation.org

Spinal Cord Society

19051 County Highway 1
Fergus Falls, MN 56537
Phone: 218.739.5252 or 218.739.5261
Fax: 218.739.5262
Website: www.scsus.org

Chiari & Syringomyelia Foundation

29 Crest Loop
Staten Island, NY   10312
Phone: 718.966.2593
Fax: 718.966.2593 (Call First)
Email: info@CSFinfo.org
Website: www.csfinfo.org

Source: National Institutes of Health; The National Institute of Neurological Disorders and Stroke

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 2/1/2012...#6126

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