ABSENT SUPERFICIAL ABDOMINAL REFLEXES IN CHILDREN WITH SCOLIOSIS - ANEARLY INDICATOR OF SYRINGOMYELIA

We describe 12 children with idiopathic scoliosis who had a persistent absent superficial abdominal reflex (SAR) on routine neurological exa mination, MRT showed syringomyelia to be present in ten. The average a ge at detection of the scoliosis was 4.3 years and at diagnosis of syr ingomyelia 6.6 years. In all ten children the SAR was consistently abs ent on the same side as the convexity of the curve, In two it was the only abnormal neurological sign. An absent SAR in patients with scolio sis is an indication for investigation for underlying syringomyelia. I n the children with syringomyelia, six had thoracic and four thoracolu mbar curves. The clinical features differed in the two groups, Patient s with thoracic curves were generally asymptomatic. Their neurological signs were subtle and none had any motor signs. By contrast, patients with thoracolumbar curves had symptoms and neurological signs. Abnorm al gait was present in all four patients with thoracolumbar curves. In three this was due to considerable motor weakness. In eight children syringomyelia was associated with a Chiari-I malformation, In seven th e syrinx was treated surgically by decompression of the foramen magnum .