Loss of pain and temperature sensation in a capelike distribution over the shoulders, lower limb paresis, hyperreflexia, and loss of bowel and bladder function are characteristic of which of the following?

Question

A. Multiple sclerosis
B. Cervical spondylosis
C. Meningomyelocele
D. Syringomyelia
E. Erb's paralysis

Answer 1

ANS: D
Rationale: The loss of pain and temperature sensation in a cape-like distribution over the shoulders, lower limb paresis, hyperreflexia, and loss of bowel and bladder function are characteristic of syringomyelia. In syringomyelia, a syrinx, or a fluid-filled cavity, develops in the spinal cord, almost always in the cervical region. Syringomyelia usually is congenital but may occur secondary to trauma or tumor. Accumulation of cerebrospinal fluid in the syrinx causes increased pressure inside the spinal cord, expanding the cavity and compressing adjacent nerve fibers. The loss of sensitivity to pain and temperature stimuli is due to interruption of spinothalamic axons crossing the midline in the anterior white commissure.