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
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