Myelopathy

Overview

Myelopathy is one of the three major symptom categories of superficial siderosis and is defined as a slowly progressive spinal cord and nerve dysfunction. Other conditions a person may have will also contribute negatively to the progression. Myelopathy may also be aggravated by arthritic changes (spondylosis), which cause narrowing of the spinal canal (spinal stenosis), resulting in compression of the spinal cord.

Signs and Symptoms For Diagnosis

  • Neck, arm, leg or lower back pain.
  • Tingling, numbness or weakness.
  • Difficulty with fine motor skills, such as writing, using utensils or buttoning a shirt
  • Difficulty walking
  • upper motor neuron signs: weakness, clumsiness, altered tonus
  • Hyperreflexia: increased or abnormal twitching or spastic reflexes 
  • Lower motor neuron signs: muscle group weakness in the area of spinal cord compromise, muscle atrophy, hyporeflexia, muscle hypotonicity or flaccidity
  • sensory deficits
  • urinary or bowel dysfuntion
  • sexual dysfunction.

Alternate Diagnosis Method

Myelopathy can also be evaluated by your neuropsychologist using Transcranial Magnetic Stimulation (TMS). This method measures the time required for the neural impulse to cross the pyramidal tracts. This time measurement is called Central Conduction Time (CCT).  Your physician will use this test to determine whether myelopathy exists, identify which section of the spinal cord is affected, and responsible for the myelopathy. It also allows your doctor to track the progression of the myelopathy.

Please refer to the individual symptoms that are grouped under the myelopathy category for more specific information.

Sources: Superficial siderosis is a rare neurologic disease characterized by progressive sensorineural hearing loss, cerebellar ataxia, pyramidal signs, and neuroimaging findings revealing hemosiderin deposits in the spinal and cranial leptomeninges and subpial layer. The disease progresses slowly, and patients may present with mild cognitive impairment, nystagmus, dysmetria, spasticity, dysdiadochokinesia, dysarthria, hyperreflexia, and Babinski signs. Additional features reported include dementia, urinary incontinence, anosmia, ageusia, and anisocoria. Superficial siderosis MedGen UID: 831707 •Concept ID: CN226971 •Finding Orphanet: ORPHA247245

Chen R, Cros D, Curra A, Di Lazzaro V, Lefaucheur JP, Magistris MR, Mills K, Rösler KM, Triggs WJ, Ugawa Y, Ziemann U. The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol. 2008 Mar;119(3):504-32.

Dr. Atkinson, Patty (March 27, 2013). “Cervical Myelopathy.” Mayo Clinic News Network. Mayo Clinic

Living With SuperficialSiderosis Website PubMed Reference Library 

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