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Condition/Disorder Synonyms

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  • Syringomyelia

  • Syrinx

  • Spinal cord cavitation

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ICD-9-CM Code

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  • 336.0 Syringomyelia and syringobulbia

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ICD-10-CM Code

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  • G95.0 Syringomyelia and syringobulbia

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Preferred Practice Pattern1

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Key Features

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Description

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  • Damage to the spinal cord due to the formation of a fluid filled cavity within the spinal cord

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Essentials of Diagnosis

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  • 4 types of syringomyelia

    • Types I, II, IV are developmental

    • Type III is acquired and associated with one of the following

      • Spinal cord tumor

      • Traumatic myelopathy

      • Spinal arachnoiditis and pachymeningitis

      • Secondary myelomalacia from cord compression, infarction or hematomyelia

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General Considerations

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  • Type III syrinx is suspected when a person with a previously stable presentation experiences changes in sensorimotor function after a spinal cord injury that extends above the level of the original injury.

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Demographics

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  • Occurs more often in people with tetra/quadriplegia than in those with paraplegia

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Clinical Findings

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Signs and Symptoms

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  • Pain

  • Spreading sensory loss

  • Spreading motor loss

  • Spasticity or involuntary muscle contraction

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Functional Implications

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  • Progressive loss of function until the problem is treated

  • Loss of functional mobility and independence with ADLs

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Possible Contributing Causes

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  • Previous spinal cord trauma is a risk factor

  • Congenital spinal malformations

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Differential Diagnosis

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  • Stenosis

  • Spondylitis

  • Arachnoiditis

  • Meningitis

  • Tangier disease

  • Fabry disease

  • Amyloid polyneuropathy

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Means of Confirmation or Diagnosis

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Laboratory Tests

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  • Spinal tap via lumbar puncture

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Imaging

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  • MRI

  • CT scan for detailed imaging

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Referrals/Admittance

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  • Neurologist

  • Neurosurgeon to repair syrinx, restore normal cerebral spinal fluid flow, and relieve pressure on spinal cord

  • Neuro-oncologist

  • Occupational therapist

  • Counselor, psychologist, neuropsychologist

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Impairments

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  • Peripheral nerve integrity

  • Gait

  • Wheelchair mobility

  • Balance

    • Static sit

    • Dynamic sit

    • Static stand

    • Dynamic stand

    • Moving outside the base of support (BOS)

  • Muscle strength

  • Muscle recruitment

  • Coordination

  • Postural control

  • Posture

  • ROM

  • Reflexes

    • Deep tendon reflex (DTR)

    • Babinski

    • Clonus

  • Muscle tone

  • Sensation

  • Bed mobility

  • Transfers

  • Endurance

  • Aerobic capacity

  • Self-care

  • Home management

  • Fine motor

  • Respiratory compromise

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Tests and Measures

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  • American Spinal Injury Association (ASIA) assessment

    • Motor

    • Sensation

    • ASIA classification neurologic level

    • Complete vs. incomplete

    • Functional mobility

      • Functional independence measure (FIMTM)

    • Wheelchair mobility

    • Transfers

    • Gait (timed up and go, 10-meter walk test, functional gait assessment, walking index for spinal cord injury)

  • Sitting and standing (for people with incomplete injuries or damage in the lower ...

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