Atypical clinical presentation of syringomyelia: A case report

R. Suozzi, G. Calandra-Buonaura, F. Cavalleri, G. Tassone, G. Galassi

Research output: Contribution to journalArticlepeer-review

Abstract

Syringomyelia, a pathologic cavity within the cervical or cervicothoracic spinal cord, typically causes slowly progressing dissociative sensory defects and lower motor neuron damage. Associated pathologies include spinal or hindbrain tumors, Chiari malformation and trauma. A 59-year-old car driver was referred because of an over 20-year history of lower extremity cramps and slowly progressive weakness affecting proximal arm muscles, of which he was not aware for a long time. In addition he had a 10-year history of UE tendon dislocations in the absence of a history of trauma. Patient's first complaint was the sudden painless rupture of left brachial biceps tendon, followed within 5 years by sharp pain in both shoulders. Since then he observed a progressive inability to raise both shoulders and, to extend elbows and hand fingers. Despite significant weakness in proximal muscles, the patient noted preserved biceps bulk. He had neither sensory symptoms, nor lower extremity complaints apart from the cramps. Repeated orthopedic evaluations concluded rotator cuff laceration. When admitted to our department (June 2000), neurologic examination revealed normal cranial nerve function and fundi, bilateral, severe asymmetric weakness, and atrophy of supraspinatus, infraspinatus, deltoid, trapetius, pectoralis and small hand muscles, with marked right scapular winging. Biceps were apparently hypertrophic due to a break of both tendons. Fasciculations were occasionally noted in his hands. Deep jerks were weakened throughout. Sensory loss for pain and temperature involved both the upper limbs and the trunk down to the T4-T7 level in the right side. Laboratory tests were normal, with the exception of mildly increased CPK levels (340 IU/l;NR

Original languageEnglish
JournalNeurological Sciences
Volume21
Issue number4 SUPPL.
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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