A 50 year old lady with weak limbs when examined was found to have burn marks on finger tips, wasted and weak hands with diminished felexes. She also has weak spastic legs and dissociated sensory loss. What is the diagnosis?

The key is B. Syringomyelia. [weak limbs, burn mark on fingertip (as pain and temperature

sensation are lost due to spinothalamic tract damage), wasted and weak hands with diminished reflexes,

weak spastic legs with dissociated sensory loss are features suggestive of Syringomyelia.

Common features are given below:

Sensory features: 1) loss of pain and temperature sensation 2) sensory loss is experienced over the

arms, shoulders and upper body 3) light touch, vibration and position senses in the feet are affected as

the syrinx enlarges into the dorsal column.

Motor features: (when lower motor neurons of the anterior horn cells are affected) 1) muscle wasting

and weakness begins in the hands and then affects the forearms and shoulders. 2) tendon reflexes are

lost. Autonomic involvement like bladder and bowel can occur. (patient.co.uk])].