Medical Treatment and Therapy for Syringomyelia

A. Pharmacological ( Non Surgical ) / Symptomatic 

There is no specific treatment and therapy for syringomyelia. But it can be treated with medication analgesics and muscle relaxan :

1. Analgesics
Neuropathic pain medication should be given multifactor working on various components of pain , including damage to neuronal activity (anticonvulsants and local anesthetics), potential improvements, lane barriers (antidepressants) or its center including the development and conduction nosiseptic response (analgesic).

2. NSAIDs ( non steroidal anti inflammation drugs)
NSAIDs are commonly used for patients with syringomyelia. If within two weeks of monotherapy is not effective then it can be combined from a higher class. Commonly used drugs are ibuprofen, acetylsalicylic tamarind, naproxen, indomethacin, mefenamic acid and piroxicam .

3. Muscle Relaxan
This drug functions as a muscle relaxant and to reduce patient anxiety. The cure include: Methocarbamol.

 

B. Surgery therapy
Several surgical techniques are performed in syringomyelia

1. Occipital and cervical decompression

To smooth the flow of CSF.

2. Laminectomy and syringotomi

After decompression, Siringo drained into the subarachnoid space through a longitudinal incision at the entry zone of the dorsal fibers (between the anterior and posterior columna) usually at C2 - C3.

3.Shunting 

Ventriculoperitoneal shunting performed when indicated on the presence of ventriculomegaly and increased intracranial pressure in progress. Usually on Chiari malformation type I which no hydrocephalus, and type II with meningomyelocele.
Asymptomatic patients diagnosed with Chiari type I malformation without syringomyelia should not be treated with surgery. While there syringomyelia some surgeons have different opinions. In patients with symptoms, then surgery should be performed.
Nearly 10 % of patients with Chiari type I malformation are hydrocephalus. The techniques used vary but most use the foramen magnum decompression.
In all surgical procedures , the foramen magnum decompression in Chiari malformation is not free of complications. Most of them enter the CSF disorders, where bias occurs in 10 % of patients, including a CSF fistula, meningitis, hydrocephalus, or progressive syringomyelia. Postoperative healing of pathological preoperative 83 % of patients had improvement.