Syringomylia Physiotherapy Percpective.pptx

it is a rare abnormality, lets explore and learn what are the common surgical options and physcial therapy options .

1. syringomylia DR. SUSAN JOSE (PT)

2. What is the structure affected? SPINAL CORD AND THE TRACTS PASSING THROUGH IT. Clinical reasoning - due to abnormal fluid filled space in the central canal that is compressing the spinal cord .  Causes- DUE OBSTRUCTED CSF FLOW Secondary to Arnold Chiari malformation Meningitis Spinal cord trauma

3. Posterior fossa hypoplasia

4. Functions IMPAIREMENT 1. Depends of the site of the syrinx- Loss of sensations - if at cervical level, UL more than lower limb. Neuropathic pain

5. 2. Spasticity 3. Progressive weakness in the arms and legs 4. Progressive scoliosis: due to paralysis of paraspinal muscles 5. B owel and bladder dysfunction 6 . S exual dysfunction– i f location is at sacral region parasympathic out flow is affected. 7. Headaches due to the increased CSF causing increased intracranial pressure.

6. Clinical symptoms that help you suspect Suddenly progressive weakness in the arms and legs Rapidly increasing scoliosis Rapidly increasing spasticity Rapidly progressive stiffness in the back, shoulders, neck, arms, or legs

7. investigations MRI gives a definitive diagnosis NORMAL

8. Surgical management FIND THE CAUSE TREAT IT! Secondary to Arnold Chiari malformation- vertebral decompression surgery Meningitis-  arachnoid scar membrane resection Spinal cord trauma If recurring syrinx- peritoneal (SPS) or sub arachnoid (SSAS) shunting.

9. Physiotherapy management FIND THE IMPAIRMENTS, MAKE PROBLEM LIST, MANAGE THEM. Try restorative approach. If restoration not possible go for compensatory approach ALWAYS SET- SMART Goals

10. Eg - STG- Inplace of - Improve standing balance XYZ should be able to lift a 10 small blocks from the floor within 15 secs independently and safely within 2 weeks .

11. REFERNCES Shenoy VS, Sampath R. Syringomyelia. [Updated 2022 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537110/ The Learning Corp. More successful brain rehabilitation: turning therapy goals into real-life activities. 2018. Available from:  https://thelearningcorp.com/brainwire/targeting-more-successful-recovery-turning-therapy-goals-into-real-life-activities/#ppm21717  (accessed 28 October 2019).

12. THANKYOU !

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