(Syringomyelia; Myelosyringosis; Analgesic paralysis with whitlow)
This neurologic condition presents skin manifestations which are fairly typical. Its onset is insidious with pain and loss of muscular power in one or both arms. Analgesia may occur at any time in the course of the disease, but the trophic changes, such as ulcers, fissures, glossiness, hyperidrosis, vesicles, bullae and whitlows leading to neuralgic pains with necrosis and mutilation and other disorders of sensation, are the most important symptoms. The muscular atrophy and the claw-like deformity of the hands may be noted and occasionally the lower extremities are involved as well. Typically the tactile sense is preserved, with loss of sensation of heat, cold and pain.
Etiology and Pathology. – The causes are obscure although cases have been attributed to traumatisms, malaria, syphilis and rheumatism. It usually appears after puberty and more frequently in males. It is generally admitted that it is of central spinal origin and cavities have been found in the central canal filled with fluid supposed to be due to the absorption of gliomata. Sclerotic changes in the posterior cornua and columns of the cord have also been noted.
Diagnosis. – This condition may bear such close resemblance to some cases of anesthetic leprosy that it may be necessary to find the bacteria of leprosy to establish the diagnosis. The typical and more external symptoms of scleroderma or well-defined glossy skin should not be mistaken for Morvan’s disease.
Prognosis and Treatment. – This disease may persist for twenty years or more and hence the prognosis is not promising. Measures to improve hygiene and diet even to the extent of medical and electrical stimulation are usually indicated. The parts affected should be treated by antiseptic and surgical methods so as to protect from injury and promote healing.