Syringomyelia and syringobulbia

1. Big picture

Syringomyelia is a chronic spinal cord disease where a fluid-filled cavity, called a syrinx, forms inside the spinal cord, usually in the central cervical cord. It is important in the exam because it produces a very characteristic sensory pattern:

Loss of pain and temperature with preserved vibration and joint position sense = dissociated sensory loss

The classic clinical picture is a patient who develops painless burns or injuries of the hands, weakness and wasting of small hand muscles, and later spastic signs in the legs.

Syringobulbia means that the syrinx extends upward into the medulla oblongata / lower brainstem, producing bulbar and cranial nerve signs such as dysphagia, dysarthria, facial sensory loss, nystagmus, vertigo, and tongue atrophy.