loss of temperature sense
Introduction
Introduction Loss of temperature: One of the symptoms of syringomyelia, loss of temperature due to disruption of spinal thalamic fibers. Spinal cervical spondylosis can result in consistent pain and loss of temperature on one or both upper and upper upper chests, while there is no change in tactile and deep senses.
Cause
Cause
1: Greenfield emphasizes that syringomyelia is a tubular cavity in the spinal cord. It extends from the neck to many segments. It should be regarded as different from the central cyst of the spinal cord. The empty water is more suitable for the latter. It is considered that the disease is the midline development of the spinal cord. As a result of the deformity, the cavity can be communicated with the central tube, and the hollow lining can be seen in the ependymal cells, and the intracapsular fluid is similar to CSF. Some people think that this disease is due to the proliferation of glial cells, and the central part of the necrosis forms a cavity.
2: congenital dysplasia syringomyelia is generally considered to be congenital dysplasia, because the disease is often accompanied by other congenital anomalies, such as: spinal cord fissure, hydrocephalus, etc., it is considered that syringomyelia is a congenital developmental defect.
3: Cerebrospinal fluid dynamics theory Some people think that due to the congenital fourth ventricle outlet occlusion, cerebrospinal fluid circulation disorder, cerebrospinal fluid pulsating pressure constantly hit the central spinal canal, leading to the continuous expansion of the central spinal cord tube, eventually forming a hollow hole.
4: syringomyelia can be secondary to spinal cord trauma, spinal glioma, cystic lesions, vascular malformations, spinal arachnoiditis, myelitis with central softening and other diseases.
Examine
an examination
Related inspection
Compound sensation examination shallow sensation examination
The patient can be diagnosed if the conscious temperature disappears. Loss of temperature is easily confused with the following symptoms:
Cervical spondyloarthropathy: Although there may be muscle atrophy of the upper limbs and segmental sensory disturbance, there is no shallow sensory separation, root pain is more common, muscle atrophy is often lighter, generally no nutritional disorder, and the lesion level is obvious. Obstruction is a rare cervical radiograph, if necessary, myelography and cervical CT or MRI can help confirm the diagnosis
Cervical ribs: can cause localized atrophy of small muscles in the hand and evidence of sensory disturbance with or without subclavian artery compression, and because of the neck ribs often associated with syringomyelia, the diagnosis can be confused. However, the sensory disturbance caused by the neck rib is usually limited to the ulnar side of the hand and forearm. The tactile dysfunction is more severe than the pain dysfunction. The upper arm tendon reflex is not affected, and there is no long beam sign. It can also help to identify the cervical spine. Establish a diagnosis.
Diagnosis
Differential diagnosis
1. Intraspinal and brainstem tumors: Both extramedullary and intramedullary tumors of the spinal cord can cause localized muscle atrophy and segmental sensory disturbance. In tumor cases, astrocytoma or ependymoma in the gray matter of the spinal cord is secreted. The accumulation of proteinaceous fluid on the tumor, the diameter of the spinal cord is widened, the posterior column of the spine and the symptoms of the nervous system can be similar to syringomyelia, especially in the lower cervical spinal cord. However, the progression of tumor cases is faster, root pain is common, and nutritional disorders are rare. Increased protein in early cerebrospinal fluid can be distinguished from this disease by identifying CTMRI in difficult cases. Occurs in children and adolescents, with obvious cross-paralysis, short duration, rapid development, and increased intracranial pressure in the late stage.
2. Cervical vertebrae joint disease: Although there may be muscle atrophy of the upper limbs and segmental sensory disturbance, but no shallow sensory separation, root pain is more common, muscle atrophy is often lighter, generally no nutritional disorders, and the lesion level is obvious segmental Sensory dysfunction is a rare cervical radiograph, if necessary, myelography and cervical CT or MRI can help confirm the diagnosis
3. Cervical ribs: can cause localized atrophy of small muscles in the hand and evidence of sensory disturbance with or without subclavian artery compression, and because of the neck ribs often associated with syringomyelia, the diagnosis can be confused. However, the sensory disturbance caused by the neck rib is usually limited to the ulnar side of the hand and forearm. The tactile dysfunction is more severe than the pain dysfunction. The upper arm tendon reflex is not affected, and there is no long beam sign. It can also help to identify the cervical spine. Establish a diagnosis.
4. Syphilis: It can be suspected in two aspects of syringomyelia in rare proliferative dural sinusitis, there may be upper limb sensory disturbance atrophy and weakness and lower limb pyramidal tract sign, but myelography can show subarachnoid obstruction and disease course Progression is also more rapid than syringomyelia. The syphilis of the spinal cord can show signs of intramedullary tumors, but the progression of the disease is rapidly disrupted and the syphilis seropositive.
The patient can be diagnosed if the conscious temperature disappears.
