Syringomyelia is a chronic, progressive condition of the spinal cord characterized by the development of cavities and gliosis of surrounding tissue resulting from destruction or degeneration of gray and white matter adjacent to the central canal of the cervical spinal cord.

The cause of the condition is unknown. However, the condition is associated with congenital anomalies, or it may develop in association with intramedullary tumors or after spinal trauma.

The condition is characterized by dissociated sensory loss of pain and temperature. As a result of the sensory loss, the person may experience a painless cut or burn. There may also be a sensory deficit over the shoulders and back. Other manifestations may include: muscular atrophy; absence of reflexes (areflexia); and fasciculations, and weakness of the legs. Thoracic kyphoscoliosis may be present. An accompanying Arnold-Chiari malformation may be present.

Tests may include: magnetic resonance imaging (MRI); computed tomography (CT) scan; and myelography. Examination of the cerebrospinal fluid (CSF) may also be done.

No specific satisfactory treatment is known. Treatment may include surgical drainage to decompress the cavity, or a chordotomy or medullary tractotomy for relief of persistent pain. Treatment may also include a cervical laminectomy if Arnold-Chiari malformation is present.

Residuals may include progressive muscle wasting and weakness. Residuals may include the development of sensory deficits in the legs. The person may develop bulbar palsy (see Diagnostic Code: 8005 Bulbar palsy); nystagmus; and sensory impairment over one or both sides of the face if the cavity extends upward into the brain. Residuals may also include increasing neurological deficits or intolerable pain.

• This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 .  [Disease subject to presumptive service connection], 38 CFR 3.309(a) [chronic disease].

• May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. In those cases where there is severe neurologic deficit, consider entitlement under 38 CFR 3.350 [Special monthly compensation ratings].

• It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.

• Disability in this field is ordinarily to be rated in proportion to the impairment of motor, sensory or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, injury to the skull, etc. In rating disability from the conditions in the preceding sentence refer to the appropriate schedule. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment in motor function, trophic changes, or sensory disturbances.  38 CFR 4.120

• With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves” 38 CFR 4.124a