A 50yo lady with weak limbs when examined was found to have burn marks on finger tips,
wasted and weak hands with diminished reflexes. She also has weak spastic legs and dissociated
sensory loss. What is the dx?
a. MS
b. Syringomyelia
c. MND
d. Guillian-barre
e. Freidriech’s ataxia
answer: B
Syringomyelia
initially pain, weakness, atrophy, loss of pain and temperature in upper extremities (central syrinx) with progressive myelopathy over years
sensory loss with preserved touch and proprioception in a band-like distribution at the level of cervical syrinx
dysesthetic pain often occurs in the distribution of the sensory loss
LMN arm/hand weakness or wasting
painless neuropathic arthropathies (Charcot’s joints), especially in the shoulder and neck due to loss of pain and temperature sensation