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Non-communicating syringomyelia: a feature of spinal cord involvement in multiple sclerosis

Katrin Weier, Yvonne Naegelin, Alain Thoeni, Jochen G. Hirsch, Ludwig Kappos, Wolfgang Steinbrich, Ernst-Wilhelm Radue, Achim Gass
DOI: http://dx.doi.org/10.1093/brain/awn068 1776-1782 First published online: 31 May 2008

Summary

In patients with multiple sclerosis (MS) non-communicating syringomyelia (NCS) has been described as an incidental finding in case studies and small case series. NCS in MS patients commonly leads to uncertainty particularly as the clinical picture of NCS is variable and surgical therapy may be considered. Up to date little is known about the prevalence and clinical importance of NCS in MS. We report the imaging and clinical characteristics of NCS formations in nine MS patients from a 1 year follow-up study in a representative group of 202 MS (4.5%) patients. Brain and spinal cord MRI was performed as part of a genetic study. NCS did commonly extend the central canal and the cord was slightly distended at the level of the syrinx. The cord and syrinx showed no tendency to change in size or shape over 1 year. Despite thorough search into the clinical history and current clinical status no definite but only minimal indications of symptoms potentially related to the NCS were found. We confirm that NCS may occur in MS patients with spinal cord pathology. It can be a subtle finding without clinical correlates. Syrinx formations are more likely to be a consequence of MS cord pathology than a coincidental finding.

  • multiple sclerosis
  • spinal cord
  • syringomyelia
  • MRI
  • Abbreviations:
    Abbreviations:
    CIS
    clinically isolated syndrome
    EDSS
    Expanded Disability Status Scale
    ETL
    echo train length
    MS
    multiple sclerosis
    NCS
    non-communicating syringomyelia
    NMO
    neuromyelitis optica
    PD
    proton density
    PPMS
    primary progressive MS
    RRMS
    relapsing remitting MS
    SPMS
    secondary progressive MS
    TA
    acquisition time
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