November 27, 1967


Author Affiliations

Washington, DC

JAMA. 1967;202(9):915. doi:10.1001/jama.1967.03130220103030

To the Editor:—  The case of syringomyelia reported by Drs. Magee and Schneider (200:795, 1967) was certainly unusual and noteworthy for its unusual clinical finding of loss of deep pain with otherwise normal sensory perception. However, the theories which they propose to rationalize this finding strike me as less attractive than another theory which might be forwarded: The syrinx caused damage to the ventral spinothalamic tract, as well as to the adjacent ventral horn, but did not involve other sensory pathways (ie, lateral spinothalamic tract or dorsal columns). The ventral spinothalamic tract is believed to carry fibers subserving deep pain and pressure, and first-order fibers course for as many as eight segments up or down the cord in dorsal white matter before synapsing and decussating to form this tract.1 Damage to this tract, then, might give dissociated loss of deep-pain sensation; and the fact that ventral spinothalamic fibers