Unmasking the Mystery of A Hidden Syrinx: Case Report of Progressive Paralysis in A 20-Year-Old Male with Intact Pain and Temperature Sensations

Abstract

Syringomyelia is a progressive neurological disorder in which a fluid-filled cyst known as syrinx forms within the spinal cord. The case of a 20-year of adult is presented with lower limb stiffness and difficulty in walking for last 3 years. For the last 1 year, he also developed stiffness of upper limbs. Upon examination, he had a spastic gait with no ataxia. There was muscle wasting of both upper and lower limbs, with fasciculation. Tone was increased with reduced power and hyperreflexia bilaterally in all four limbs with positive ankle clonus and upgoing plantars bilaterally. Sensory system, cerebellum and higher motor functions were intact. MRI scan revealed an abnormal intramedullary multifocal T2WI hyper intense signal in cervical and thoracic spinal cord consistent with syrinx and he was diagnosed with Syringomyelia. This case is an uncommon presentation of Syringomyelia presenting with predominantly upper motor neuron lesion without sensory involvement.