Symptomatic arrhythmias due to syringomyelia-induced severe autonomic dysfunction

摘要: Syringomyelia is characterized by cavity formation in the spinal cord, most often at C2-Th9 level. Clinical manifestation reflects extent and localization of cord injury. Cases: 20-year old woman was admitted for recurrent rest-related presyncopes with sudden manifestation. Paroxysms sinus bradycardia SA AV blocks were repeatedly documented during symptoms. There normal echocardiographic finding, (para) infectious etiology not proved. Character ECG findings raised suspicion on neurogenic cause. Autonomic nervous system testing demonstrated abnormalities reflecting predominant sympathetic dysfunction. Suspicion incipient myelopathy subsequently confirmed MRI, which discovered syringomyelia Th5 level as only pathology. A 52-year man hypotrophic quadruparesis resulting from perinatal brain injury sent 2-years lasting symptoms (sudden palpitation, sweating, muscle tightness, shaking) progressive worsening. Symptoms occurred association increase rhythm rate blood pressure that provoked minimal physical activity. Presence significant autonomic dysregulation baroreflex hyperreactivity orthostatic test symptomatic postural tachycardia verticalization-associated hypertension MRI revealed C7 Th7 affecting centers these levels. Sympathetic fibers dysfunction C-Th may cause arrhythmic