What is Syringobulbia?
Syringobulbia is pathological condition which is characterized by development of fluid filled cavities, also known by the name of syrinx in the spinal cord which may also involve the brainstem. Normally it occurs as a very small gap in the lower part of the brainstem which affects one or more cranial nerves resulting in various symptoms to include facial palsies. Additionally, the sensory pathways may also get impaired due to this condition due to obstruction caused by the collection of the cerebrospinal fluid. Syringobulbia is almost always associated with another similar condition called Syringomyelia but in this case the syrinx does not extend beyond the spinal cord.
What Causes Syringobulbia?
As of now the exact cause of Syringobulbia is not clear but when this condition develops there is accumulation of the cerebrospinal fluid around the spinal cord forming these fluid filled cysts. Syringobulbia may also be caused due to a spinal cord tumor. Tethering of the spinal cord may also cause this condition.
What are the Symptoms of Syringobulbia?
Syringobulbia advances quite slowly and initially may cause the following symptoms
- Sensory loss in the facial region is one of the symptoms of Syringbulbia.
- Fibrillation of the tongue muscles
- Hoarseness of voice
- Unstable gait
- In some cases a person suffering from Syringobulbia may also have tinnitus
- Rarely, there may also be frequent nausea and vomiting in people with Syringobulbia.
How is Syringobulbia Diagnosed?
To begin with, the physician will take a detailed history as to the duration of the symptoms. The physician will then perform a physical examination looking for any classic features of Syringobulbia. If Syringobulbia is suspected, then the physician will order an MRI scan of the brain and spinal cord to look for accumulation of the CSF fluid and any fluid filled cavity around the spinal cord. In almost all the cases, the fluid filled cavity is diagnosed on an MRI thus confirming the diagnosis of Syringobulbia.
How is Syringobulbia Treated?
Treating Syringobulbia depends on severity and progression of the disease and how severe the symptoms are. In cases where this condition does not produce any symptoms then just observation is the route to go as recommended by physicians by doing serial MRIs to check on the status of the syrinx but in case if the patient is symptomatic then surgery is the most preferred way to treat Syringobulbia. The surgical procedure involves:
Surgical Treatment for Syringobulbia-Draining the Cyst: In order to drain the fluid from the cyst the surgeon inserts a shunt containing a tube and a valve with one end of the tube being attached to the cyst and the other end being attached to other part of the body which is usually the abdomen and the fluid is drained from the cyst using this shunt.
Surgical Treatment for Syringobulbia-Removing Obstruction: In case if there is a tumor or an abnormal growth restricting the flow of the CSF then removal of the tumor is done so as to restore normal flow of the CSF and allowing the fluid from the cysts to drain.