How is Syringomyelia diagnosed?

How is Syringomyelia diagnosed?

Syringomyelia is a rare neurological condition characterized by the formation of a fluid-filled cavity or syrinx within the spinal cord. Diagnosing syringomyelia involves a comprehensive evaluation of the patient's medical history, physical examination, and various diagnostic tests. The process aims to identify the presence of a syrinx, determine its location, and assess the underlying cause.

Medical History

The first step in diagnosing syringomyelia is obtaining a detailed medical history from the patient. The healthcare provider will inquire about the patient's symptoms, their onset, duration, and progression. They will also ask about any previous medical conditions, surgeries, or injuries that may be relevant to the development of syringomyelia. Understanding the patient's medical history helps the healthcare provider to establish a baseline and guide further diagnostic investigations.

Physical Examination

During the physical examination, the healthcare provider will assess the patient's neurological function and look for any signs or symptoms that may indicate syringomyelia. They will evaluate muscle strength, reflexes, sensation, coordination, and balance. The presence of specific neurological deficits can provide valuable clues to the diagnosis of syringomyelia.

Diagnostic Imaging

Diagnostic imaging plays a crucial role in confirming the presence of a syrinx and determining its location within the spinal cord. The following imaging techniques are commonly used:

1. Magnetic Resonance Imaging (MRI): This is the gold standard imaging modality for diagnosing syringomyelia. MRI uses powerful magnets and radio waves to create detailed images of the spinal cord and surrounding structures. It can accurately visualize the syrinx, its size, extent, and any associated abnormalities. MRI can also help identify the underlying cause of syringomyelia, such as a Chiari malformation or spinal cord tumor.


2. Computed Tomography (CT) Scan: CT scans may be used in cases where MRI is contraindicated or unavailable. While not as sensitive as MRI in detecting syrinx, CT scans can provide valuable information about bony abnormalities, fractures, or other structural issues that may contribute to syringomyelia.

Other Diagnostic Tests

In addition to imaging, several other tests may be performed to aid in the diagnosis of syringomyelia:

• Electromyography (EMG) and Nerve Conduction Studies (NCS): These tests evaluate the electrical activity of muscles and nerves, helping to assess any damage or dysfunction caused by the syrinx.


• Somatosensory Evoked Potentials (SSEP): SSEP measures the electrical signals generated by sensory pathways in response to stimulation. It can help evaluate the integrity of sensory pathways affected by the syrinx.


• Spinal Tap (Lumbar Puncture): In some cases, a lumbar puncture may be performed to analyze the cerebrospinal fluid (CSF) for abnormalities. However, this test is not specific for syringomyelia and is usually reserved for ruling out other conditions.

Consultation with Specialists

Given the complexity of syringomyelia, consultation with various specialists may be necessary to confirm the diagnosis and determine the underlying cause. Neurologists, neurosurgeons, and radiologists often collaborate to interpret the diagnostic findings and develop an appropriate treatment plan.

In conclusion, diagnosing syringomyelia involves a thorough evaluation of the patient's medical history, a comprehensive physical examination, and the use of various diagnostic tests. The key diagnostic tool is an MRI scan, which can accurately visualize the syrinx and identify any associated abnormalities. Other tests, such as EMG, NCS, SSEP, and lumbar puncture, may be performed to provide additional information. Collaboration between different specialists is crucial in confirming the diagnosis and determining the underlying cause of syringomyelia.