Intended for healthcare professionals



BMJ 2017; 358 doi: (Published 28 September 2017) Cite this as: BMJ 2017;358:j3811
  1. Toshihiko Takada, assistant professor,
  2. Michio Hayashi, lecturer,
  3. Jun Miyashita, assistant professor,
  4. Teruhisa Azuma, associate professor
  1. Department of general medicine, Shirakawa satellite for teaching and research, Fukushima Medical University, Fukushima, Japan
  1. Correspondence to T Takada ttakada{at}

A 64 year old woman presented with left upper abdominal pain, which was first felt as a “pins and needles” sensation five years earlier and gradually evolved to stabbing pain. There was no abdominal tenderness upon palpation. Neurological examination found allodynia and impaired pain and temperature sensation with preserved touch sensation at the left T8 level. T2 weighted magnetic resonance imaging showed left dominant syringomyelia at T7-9 (fig 1). In patients with syringomyelia, fluid filled cavities develop in the spinal cord. Dysaesthetic abdominal pain can occur if the mid to lower thoracic spine is involved.1 Although pain is one of the prominent features of syringomyelia, the majority of patients also present with neurological deficits such as weakness.2 Clinicians should be aware of neurological causes of abdominal pain when there is no apparent intra-abdominal pathology.


  • Patient consent obtained.


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