- Author: Hassan Ahmad Hassan Al-Shatoury, MD, PhD, MHPE; Chief Editor: Selim R Benbadis, MD more...
No specific medication is indicated for treatment of syringomyelia. However, analgesics and muscle relaxants may be given for symptomatic treatment.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs commonly are used as analgesics in patients with syringomyelia. If one class seems to be ineffective after a 2-week trial, a formulation from another class may be tried. The most commonly used drugs are ibuprofen, acetylsalicylic acid, naproxen, indomethacin, mefenamic acid, and piroxicam.
One of propionic acid derivatives group. Effective inhibitor of cyclooxygenase, which is responsible for biosynthesis of prostaglandins; rapidly absorbed after PO administration; half-life in plasma is about 2 h; passes slowly into synovial spaces and may remain there in higher concentration as concentrations in plasma decline; excretion is rapid and complete, mainly in urine as metabolites or their conjugates.
Treats mild to moderately severe pain and headache. Inhibits prostaglandin synthesis, which prevents formation of platelet-aggregating thromboxane A2; acts on heat-regulating center of hypothalamus and vasodilates peripheral vessels to reduce fever.
For relief of mild to moderately severe pain; inhibits inflammatory reactions and pain by decreasing activity of cyclooxygenase, which is responsible for prostaglandin synthesis.
Rapidly absorbed. Metabolism occurs in liver by demethylation, deacetylation, and glucuronide conjugation. Inhibits prostaglandin synthesis.
Decreases activity of cyclooxygenase, which in turn inhibits prostaglandin synthesis. These effects decrease formation of inflammatory mediators.
Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis
These agents treat muscle spasms to decrease the patient's level of discomfort.
Skeletal muscle relaxant used in conjunction with other therapeutic efforts to treat pain and discomfort associated with musculoskeletal conditions. Acts on CNS to relax certain reflexes.
Nakanishi K, Uchiyama T, Nakano N, et al. Spinal syringomyelia following subarachnoid hemorrhage. J Clin Neurosci. 2012 Apr. 19(4):594-7. [Medline].
Kim J, Kim CH, Jahng TA, Chung CK. Clinical course of incidental syringomyelia without predisposing pathologies. J Clin Neurosci. 2012 Feb 29. [Medline].
Gardner WJ. Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J Neurol Neurosurg Psychiatry. 1965 Jun. 28:247-59. [Medline].
Williams B. Progress in syringomyelia. Neurol Res. 1986 Sep. 8(3):130-45. [Medline].
Oldfield EH, Muraszko K, Shawker TH, Patronas NJ. Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils. Implications for diagnosis and treatment. J Neurosurg. 1994 Jan. 80(1):3-15. [Medline].
Viswanatha B. Syringomyelia with syringobulbia presenting as vocal fold paralysis. Ear Nose Throat J. 2009 Jul. 88(7):E20. [Medline].
Tubbs RS, Bailey M, Barrow WC, Loukas M, Shoja MM, Oakes WJ. Morphometric analysis of the craniocervical juncture in children with Chiari I malformation and concomitant syringobulbia. Childs Nerv Syst. 2009 Jun. 25(6):689-92. [Medline].
Nacir B, Arslan Cebeci S, Cetinkaya E, Karagoz A, Erdem HR. Neuropathic arthropathy progressing with multiple joint involvement in the upper extremity due to syringomyelia and type I Arnold-Chiari malformation. Rheumatol Int. 2009 Jun 23. [Medline].
Ono A, Suetsuna F, Ueyama K, Yokoyama T, Aburakawa S, Numasawa T. Surgical outcomes in adult patients with syringomyelia associated with Chiari malformation type I: the relationship between scoliosis and neurological findings. J Neurosurg Spine. 2007 Mar. 6(3):216-21. [Medline].
Cardoso M, Keating RF. Neurosurgical management of spinal dysraphism and neurogenic scoliosis. Spine (Phila Pa 1976). 2009 Aug 1. 34(17):1775-82. [Medline].
Kiran NA, Kasliwal MK, Suri A, Mahapatra AK. Giant posterior fossa arachnoid cyst associated with syringomyelia. Clin Neurol Neurosurg. 2010 Feb 4. [Medline].
Lucchetta M, Cagnin A, Calderone M, Manara R, Rotilio A, Briani C. Syringomyelia associated with Chiari I malformation. Neurol Sci. 2009 Sep 19. [Medline].
Prat R, Galeano I. Pain improvement in patients with syringomyelia and Chiari I malformation treated with suboccipital decompression and tonsillar coagulation. J Clin Neurosci. 2009 Apr. 16(4):531-4. [Medline].
Falci SP, Indeck C, Lammertse DP. Posttraumatic spinal cord tethering and syringomyelia: surgical treatment and long-term outcome. J Neurosurg Spine. 2009 Oct. 11(4):445-60. [Medline].
Sixt C, Riether F, Will BE, Tatagiba MS, Roser F. Evaluation of quality of life parameters in patients who have syringomyelia. J Clin Neurosci. 2009 Oct 7. [Medline].
Attal N, Parker F, Tadie M, et al. Effects of surgery on the sensory deficits of syringomyelia and predictors of outcome: a long term prospective study. J Neurol Neurosurg Psychiatry. 2004 Jul. 75(7):1025-30. [Medline].
Carroll AM, Brackenridge P. Post-traumatic syringomyelia: a review of the cases presenting in a regional spinal injuries unit in the north east of England over a 5-year period. Spine. 2005 May 15. 30(10):1206-10. [Medline].
Chang HS, Nakagawa H. Hypothesis on the pathophysiology of syringomyelia based on simulation of cerebrospinal fluid dynamics. J Neurol Neurosurg Psychiatry. 2003 Mar. 74(3):344-7. [Medline].
Colombo A, Cislaghi MG. Familial syringomyelia: case report and review of the literature. Ital J Neurol Sci. 1993 Dec. 14(9):637-9. [Medline].
Greitz D. Unraveling the riddle of syringomyelia. Neurosurg Rev. 2006 Oct. 29(4):251-63; discussion 264. [Medline].
Gruber DP, Crone KR. Neuroendoscopy. Grossman RG, Loftus CM, eds. Principles of Neurosurgery. 2nd ed. Philadelphia: Lippincott-Raven; 1998. 757-62.
Huewel N, Perneczky A, Urban V, Fries G. Neuroendoscopic technique for the operative treatment of septated syringomyelia. Acta Neurochir Suppl (Wien). 1992. 54:59-62. [Medline].
Kaminsky SB, Clark CR, Traynelis VC. Operative treatment of cervical spondylotic myelopathy and radiculopathy. A comparison of laminectomy and laminoplasty at five year average follow-up. Iowa Orthop J. 2004. 24:95-105. [Medline].
Koyanagi I, Iwasaki Y, Hida K, Houkin K. Clinical features and pathomechanisms of syringomyelia associated with spinal arachnoiditis. Surg Neurol. 2005 Apr. 63(4):350-5; discussion 355-6. [Medline].
Lin JW, Lin MS, Lin CM, Tseng CH, Tsai SH, Kan IH. Idiopathic syringomyelia: case report and review of the literature. Acta Neurochir Suppl. 2006. 99:117-20. [Medline].
Madsen III PW, Green BA, Bowen BC. Syringomyelia. Herkowitz HN, Garfin SR, Balderston RA, et al, eds. The Spine. 4th ed. Philadelphia: WB Saunders Company; 1999. 2: 1431-59.
Mancall EL. Syringomyelia. Rowland LP, ed. Merritt's Textbook of Neurology. 8th ed. Philadelphia: Lea & Febiger; 1989: 687-91.
Milhorat TH, Capocelli AL Jr, Kotzen RM. Intramedullary pressure in syringomyelia: clinical and pathophysiological correlates of syrinx distension. Neurosurgery. 1997 Nov. 41(5):1102-10. [Medline].
Milhorat TH, Kotzen RM, Mu HT, et al. Dysesthetic pain in patients with syringomyelia. Neurosurgery. 1996 May. 38(5):940-6; discussion 946-7. [Medline].
Mueller D, Oro' JJ. Prospective analysis of self-perceived quality of life before and after posterior fossa decompression in 112 patients with Chiari malformation with or without syringomyelia. Neurosurg Focus. 2005 Feb 15. 18(2):ECP2. [Medline].
Oakes WJ. Chiari malformation and syringomyelia. Rengachary SS, Wilkins RA, eds. Principles of Neurosurgery. St. Louis, Mo: Wolfe; 1994. 9.1-9.17.
Penagaricano JA, Linskey ME, Ratanatharathorn V. Accelerated cerebral vasculopathy after radiation therapy to the brain. Neurol India. 2004 Dec. 52(4):482-6. [Medline].
Rhoton AL, Hamilton AJ. Chiari malformation and syringomyelia. Benzel EC, ed. Spine Surgery: Techniques, Complication Avoidance, and Management. Boston: Churchill-Livingstone; 1999. 2: 793-812.
Rusbridge C, Greitz D, Iskandar BJ. Syringomyelia: current concepts in pathogenesis, diagnosis, and treatment. J Vet Intern Med. 2006 May-Jun. 20(3):469-79. [Medline].
Simon RP, Aminoff MJ, Greenberg DA. Clinical Neurology. 4th ed. Norwalk, Conn: Appleton-Lange; 1999. 220-1.
Sudo K, Miyazaki Y, Tajima Y. Spontaneous resolution of idiopathic syringomyelia. Neurology. 2002 May 28. 58(10):1576-7; author reply 1577. [Medline].
Wisoff JH. Chiari Malformations and Hydromyelia. Tindall GT, Cooper PR, Barrow D, eds. The Practice of Neurosurgery. Baltimore: Williams & Wilkins; 1995. 3: 2743-53.