Anti-MAG IgM antibody levels in patients with IgM monoclonal gammopathy with and without neuropathy

The clinical features of 31 cases of syringomyelic syndrome, confirmed by metrizamide CT myelography (CTM) or magnetic resonance imaging (MRI), were analysed. Bilateral suspended sensory disturbance, previously regarded as a characteristic feature, was encountered in only 2 cases (6.5%). Thirteen patients (41.9%) showed no motor deficits of the upper limbs and 7 patients (22.6%) did not have weakness or atrophy in any of the four extremities. Cervical segmental signs were absent in 7 cases (22.6%) and in 2 (6.5%) signs were only present in the lower limbs. Scoliosis and foot deformity, such as pes cavus or equinovarus, were seen in 17 (54.8%) and 5 cases (16.1%) respectively. These skeletal abnormalities were initial symptoms in some childhood cases. In syringomyelic syndrome, clinical features are variable with many atypical clinical manifestations, apart from the previously recognized characteristic clinical features.