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Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation.

Publication ,  Journal Article
Nadel, JL; Ziats, C; Mossner, JM; Starr, JB; Smith, BW; Kelly, MP; Muraszko, KM; Farley, FA; Maher, CO; Garton, HJL; Strahle, JM
Published in: J Clin Neurosci
April 2022

An abnormal or absent superficial abdominal reflex (SAR) may be associated with an underlying spinal cord syrinx. The sensitivity of an abnormal or absent SAR and the relationship to Chiari malformation type I (CM-I) or syrinx morphology has not been studied. We aimed to describe the relationship between SAR abnormalities and syrinx size, location, and etiology. Children who underwent brain or c-spine MRI over 11 years were reviewed in this retrospective cohort study. Patients with idiopathic and CM-I-associated syringes (axial diameter ≥ 3 mm) were included. Clinical examination findings (including SAR) and imaging characteristics were analyzed. Of 271 patients with spinal cord syrinx, 200 had either CM-I-associated or idiopathic syrinx, and 128 of these patients had SAR-evaluation documentation. Forty-eight percent (62/128) had an abnormal or absent reflex. Abnormal/absent SAR was more common in patients with CM-I-associated syrinx (61%) compared with idiopathic syrinx (22%) (P < 0.0001). Abnormal/absent SAR was associated with wider syringes (P < 0.001), longer syringes (P < 0.05), and a more cranial location of the syrinx (P < 0.0001). Controlling for CM-I, scoliosis, age, sex, cranial extent of syrinx, and syrinx dimensions, CM-I was independently associated with abnormal or absent SAR (OR 4.2, 95% CI 1.4-14, P < 0.01). Finally, the sensitivity of SAR for identifying a patient with syrinx was 48.1%. An abnormal/absent SAR was present in most patients with CM-I-associated syrinx but in a minority of patients with idiopathic syrinx. This has implications for pathophysiology of CM-I-associated syrinx and in guiding clinical care of patients presenting with syrinx.

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Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

April 2022

Volume

98

Start / End Page

1 / 5

Location

Scotland

Related Subject Headings

  • Syringomyelia
  • Scoliosis
  • Retrospective Studies
  • Reflex, Abnormal
  • Reflex, Abdominal
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Humans
  • Child
  • Arnold-Chiari Malformation
 

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Chicago
ICMJE
MLA
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Nadel, J. L., Ziats, C., Mossner, J. M., Starr, J. B., Smith, B. W., Kelly, M. P., … Strahle, J. M. (2022). Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation. J Clin Neurosci, 98, 1–5. https://doi.org/10.1016/j.jocn.2021.12.037
Nadel, Jeffrey L., Catherine Ziats, James M. Mossner, Jordan B. Starr, Brandon W. Smith, Michael P. Kelly, Karin M. Muraszko, et al. “Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation.J Clin Neurosci 98 (April 2022): 1–5. https://doi.org/10.1016/j.jocn.2021.12.037.
Nadel JL, Ziats C, Mossner JM, Starr JB, Smith BW, Kelly MP, et al. Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation. J Clin Neurosci. 2022 Apr;98:1–5.
Nadel, Jeffrey L., et al. “Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation.J Clin Neurosci, vol. 98, Apr. 2022, pp. 1–5. Pubmed, doi:10.1016/j.jocn.2021.12.037.
Nadel JL, Ziats C, Mossner JM, Starr JB, Smith BW, Kelly MP, Muraszko KM, Farley FA, Maher CO, Garton HJL, Strahle JM. Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation. J Clin Neurosci. 2022 Apr;98:1–5.
Journal cover image

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

April 2022

Volume

98

Start / End Page

1 / 5

Location

Scotland

Related Subject Headings

  • Syringomyelia
  • Scoliosis
  • Retrospective Studies
  • Reflex, Abnormal
  • Reflex, Abdominal
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Humans
  • Child
  • Arnold-Chiari Malformation