Spinal shock is a painful process, caused by damage to the spinal cord due to trauma. It appears as areflexia and lack of sensitivity below the ...
Disease of syringomyelia: the true causes and treatment
Syringomyelia is a chronic CNS disease in which cavities are formed in the channels of the spinal cord. Most often affected cervical and thoracic spine, less often lumbar.
In very rare cases, the medulla oblongata is involved in the process. This ailment is quite rare and is most common in men.
Mechanism of the development of the disease
As a result of the development of the disease, the spinal canal expands, after which the fluid flowing through it collides with obstacles, bends around them, and cavities appear at the places of such bypass. With time, glial cells begin to grow in these cavities.
These cells are ancillary cells of the nervous tissues, nerve impulses are not transmitted through them. The absence of nerve impulses between the spinal cord and the organs leads to the appearance of the main symptoms characteristic of syringomyelia.
From the onset of the disease to the first symptoms may take several decades.
There are two types of disease:
- The communicating syringomyelia - the resulting cavities are connected to the canal of the spinal cord.
- Non-communicating syringomyelia - the cavities are isolated from the canal.
The main causes of
The causes that can cause a violation are divided into two types:
- Primary - these include congenital disorders of embryo development. In this case, cavity formation occurs in the first three months of intrauterine development. Factors contributing to this may be the use of certain medications, alcohol, smoking and other adverse factors, heredity. In more than 80% of cases, congenital syringomyelia is accompanied by Arnold-Chiari anomaly and dysraphic status.
- Secondary - these include certain diseases( tumors, inflammation of the membranes of the brain), trauma, surgical interventions.
Symptoms of the disorder and diagnosis of
The disease develops long and slowly, so in the early stages of symptomatology is not manifested. Typically, the first symptoms appear in childhood, but they are so insignificant that they often do not pay attention. More serious symptoms are manifested in 20-30 years and at the same time syringomyelia is most often diagnosed.
The doctor can suspect syringomyelia from three characteristic groups of disorders:
- Sensitivity disorders .Such violations lead to the fact that the patient's upper body and hands no longer feel the temperature and pain. This leads to frequent burns, cuts. Thus tactile and muscular sensitivity are saved. If the process is localized in the lower parts of the spine, then the sensitivity of the hands can persist. A little later, dull, but prolonged and painful pain joins. Paresthesia can also join, which manifests itself in the form of numbness of the skin, tingling, "creepy", a feeling of tightness.
- Vascular disorders of , which appear in the first stage in the form of increased sweating. With the development of the disease there is peeling and dry skin. Even the smallest burns and cuts that appear as a result of loss of sensitivity, slowly heal, cracks and ulcers may appear. The nail plates are severely damaged: they become weak, constantly break down. In the last stages, diseases of large joints of the extremities may appear. Trophic changes in bones are common symptoms. Most often it manifests itself in the form of kyphoscoliosis of the thoracic region. Osteoporosis of the upper extremities is also often found.
- 's motor disorders manifest themselves as a paresis. At first, the muscles of the hands are atrophied. It becomes difficult for a person to take small items, write, button up buttons, lace shoes. There is a so-called "clawed brush".Gradually the tendon reflexes decrease. If the lateral parts of the spinal cord are touched with syringomyelia, similar symptoms appear in the lower extremities. Motor disorders occur later than other symptoms.
If there is a syringomyelia of the cervical region, then Horner's syndrome is added to these symptoms, manifested in the westernization of the eyeball, ovulation of the eyelids and dilated pupils.
The diagnosis is performed mainly on the basis of existing symptoms. As a rule, they are so characteristic that the diagnosis is beyond doubt.
In case the neurologist needs confirmation, he appoints additional examinations. These include X-rays, with which you can see osteoporosis, the destruction of bones. They can also do MRI or myelography, a lumbar puncture. These methods allow you to see the cavities in the spinal cord.
Medical care - what are the methods of the doctors?
Syringomyelia is an incurable disease. Therefore, the main goal of his treatment is to eliminate symptoms and stop the disease itself.
There are several ways to treat the disorder:
- X-ray irradiation ( one of the types of radiotherapy) - is considered very effective in the early stages of the disease. In this case, the patient, as a rule, weakens or disappears completely painful sensations, discomfort disappears in the upper limbs. At later stages, such therapy is considered ineffective and does not bring relief.
- Recently proserin therapy has proved itself well. Proserin improves the transfer of impulses between cells, which greatly facilitates the human condition. Such therapy gives its fruits only at the initial stages. Unfortunately, Proserin only removes symptoms, but in no way prevents the formation of cavities.
- Another method that helps slow the progression of the disease and reduce the manifestation of symptoms is treatment with radioactive phosphorus or iodine .These substances are able to accumulate in glial cells and significantly stop their growth.
- Medication Therapy .The main drugs aimed at treating syringomyelia are dehydrating and pain medications, vitamins, neuroprotectors.
- Physiotherapy methods - aimed primarily at reducing pain syndrome. These methods include UHF, electrophoresis, radon baths, acupuncture.
- Surgical intervention is an extreme measure. This type of treatment is used only in the very late stages, when the other methods did not have the proper effect. The main indication for the operation is the paresis of the upper or lower extremities.
- is also of great importance for the correct power supply of .Since the patient lacks calcium and vitamin A, then in his diet must be present sour-milk products, carrots, spinach, cabbage, beets.
Treatment of syringomyelia occurs throughout the life of the patient. The methods and scope of the methods used depend on the stage of the disease. Drug treatment is conducted from two to four times a year.
Prognosis of the disease
True syringomyelia does not lead to death, but significantly worsens the quality of life of the patient. In most cases, the periods of exacerbation and remission alternate. In a small number of patients, the disease does not progress at all. At late the disease leads to disability of the patient.
Much worse is the disease, complicated by infectious diseases. In this case, the risk of developing sepsis, bronchopneumonia, kidney disease and the genitourinary system increases.
Lethal outcome can occur if the process involves not only the dorsal but also the medulla oblongata. In this case, frequent complications are breathing disorders( bulbar paralysis), swallowing, which leads to the patient's death. The most common complications are with secondary syringomyelia.
Methods of prophylaxis of
Unfortunately, at the moment there are no primary methods of prevention of the disease.
As one of the factors that can trigger a violation is spinal injury, as well as various infections, then preventive measures include the prevention of injuries, as well as their serious treatment.
The measures for secondary prevention include early diagnosis. Detection of the disease at an early stage, makes it possible to apply effective methods of treatment, slow the course of the disease and significantly prolong the patient's performance.