Spinothalamic damage in syringomyelia

Usually the damage to the spinothalamic system is initially more pronounced on one side than the other.

Temperature and pain sensation are lost:

• distribution of loss is characteristically over the arms and shoulders
• during periods of disease progression there may be pain over the affected limb
• the Vth cranial nerve may be damaged resulting in dissociated sensory loss over the face starting at the back, progressing forward and sparing the tip of the nose and lips

Light touch, vibration and proprioception are retained.

Complications of the deafferentation include:

• hypertrophic destruction of joints (Charcot's joints)
• injuries e.g. burns are not immediately recognised