Syringomyelia and Complex Regional Pain Syndrome as Complications of Multiple Sclerosis
Asha Das, MD;
K. Puvanendran, FRCP
Arch Neurol. 1999;56:1021-1024.
Objective To describe a patient from Southeast Asia with the optic-spinal phenotype of multiple sclerosis who developed syringomyelia and resultant complex regional pain syndrome (formerly named reflex sympathetic dystrophy).
Design Case report.
Setting Department of neurology at a tertiary care hospital in the Republic of Singapore.
Patient A 53-year-old Chinese woman with a history of optic neuritis developed an episode of left hemiparesis leading to a diagnosis of multiple sclerosis. Serial neuroimaging studies revealed an active demyelinating plaque in the cervical area that later progressed into a syrinx. Over a period of 1 year she also developed signs of sympathetic dysfunction including Horner syndrome of the left eye and complex regional pain syndrome in the left hand.
Conclusions A case of the optic-spinal phenotype of multiple sclerosis that is commonly observed in Southeast Asia is described. This characteristically tissue-destructive form of multiple sclerosis resulted in syringomyelia complicated by a complex regional pain syndrome. Possible pathogenic mechanisms for these associations are discussed.
From the Departments of Neurology, National Neuroscience Institute/Tan Tock Seng Hospital (Dr Das) and Singapore General Hospital (Dr Puvanendran), Singapore.
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