Sandbox:Eman

1.overvew;Syringomyelia is a generic term referring to a disorder in which a cyst or tubular cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. Since the spinal cord connects the brain to nerves in the extremities, this damage may result in pain, weakness, and stiffness in the back, shoulders, arms, or legs. Other symptoms may include headaches and a loss of the ability to feel extremes of hot or cold, especially in the hands {wikipedia}= Syringomyelia is a spinal cord cavitation, which is a central dilation due to cystic degradation expands and destroyed the spinal cord. Caused by an injury, tumors or congenital malformation like hernia. The damage can Effect the brain and nerves, that leade to Bilateral loss of pain and temperature sensation in upper extremities. weakness, stiffness, hyperReflexives in lower extremities with hyposcoliosis.

2.Risk factors for the development of syringomyelia depend on the underlying etiology: = The main risk factors associated with the development of syringomyelia are based on the underlying causes.

3.The natural course of disease in syringomyelia is unpredictable(history)= The essential Course of disease in Syringomyelia is temperamental.

4.80% of patients respond to surgical treatment in terms of hault to progression of symptoms and mild relief.{prognosis)= The symptoms of 80% of patients usually end due to their response to surgical treatment, as well a mild cure.

5{.Physical examination} findings of syringomyelia may include the= The following includes how syringomyelia might be revealed

6.Spinal MRI may help to diagnose and follow up syringomyelia. It is characterized by the following findings{MRI}?

Syringomyelia may be diagnosed as an incidental finding on CT scan. However, delayed CT scan may have a diagnostic importance in early cases of syringomyelia without clinical manifestaions.(CT)?

7.It uses a contrast material combined with x ray or CT to image spinal cord in case of syringomyelia. However, CT metrimised myelography is more sensitive to diagnose syringomyelia as compared to conventional myelography.{mylogram}?

management??

reference:25,37,38,39,65

Treatment for viral conjunctivitis is aimed at symptomatic relief and not to eradicate the self-limiting viral infection. Resolution of conjunctivitis can take up to 3 weeks. Treatment includes using artificial tears for lubrication four times a day or up to ten times a day with preservative-free tears. Cool compresses with a wet washcloth to the periocular area may provide symptomatic relief. Preventing the spread of infection to the other eye or other people requires the patient to practice good hand hygiene with frequent washing, avoidance of sharing towels or linens, and avoiding touching their eyes. A person is thought to shed the virus while their eyes are red and tearing.

If a membrane or pseudomembrane is present, it can be peeled at the slit lamp to improve patient comfort and prevent any scar formation from occurring. These membranes can either be peeled with a jeweler forceps or a cotton swab soaked with topical anesthetic. Topical steroids can help with the resolution of symptoms. However, they can also cause the shedding of the virus to last longer. Patients should be informed that they are highly contagious and should refrain from work or school until their symptoms resolve. While using steroids, they may still shed the virus without the visual symptoms that would indicate that they have an infection. Steroids should be reserved for patients with decreased vision due to their subepithelial infiltrates or severe conjunctival injection causing more the expected discomfort.

In rare cases, topical antiviral agents may be prescribed to manage HSV and varicella-zoster conjunctivitis.

Some patients may benefit from antihistamines.

As we all know, the 2019 novel coronavirus disease (COVID-19) infected by SARS-CoV-2 are spreading worldwide. It was reported that there were different clinical features between pediatric and adult patients with COVID-19 Our previous study had shown that conjunctivitis symptoms were found in a minority of adult patients confirmed COVID-19 with positive results of viral nucleic acid in conjunctival swab samples . Nevertheless, there are no reports in the medical literature at this time, to our knowledge, on children infected by SARS-CoV-2 with ocular abnormalities. Here we firstly report an infected boy characterized by conjunctivitis and eyelid dermatitis without any other symptom. The child, 2 years and 10 months old, On day 7 of confinement, the child presented with conjunctivitis and eyelid dermatitis. After treatment depending on the national protocol in China, conjunctivitis and eyelid dermatitis gradually disappeared 5 days later. From days 10 to 12 of admission, negative results of viral nucleic acid twice in 48 h, with positive IgG but negative IgM of the virus in serum, indicated that the virus had been cleared .The child left hospital on March 7, 2020, with systemic symptoms until now. Don’t The pupillary exam in the pediatric population is a vital part of any clinician's workup. In the right clinical setting, pupillary abnormalities such as anisocoria, light-near dissociation, an afferent pupillary defect, and paradoxic pupillary constriction in the dark can be red flags that trigger further examination and workup. Through both careful physical examination and detailed history-taking and observation, potentially vision- and life-threatening conditions can be detected. Keywords: Horner syndrome; Pupil; dorsal midbrain syndrome; paradoxic pupils; third nerve palsy.