Actually after a bad accident prior to BFS , one should always consider syringomyelia especially when this person never had any somatisation or anxiety/stress symtoms before BFS. We actually had a case here of syringomyelia after a bad bike accident with trauma and spine damage, and it presented very similar to classic BFS. Chiari Malformation and Syringomyela are very very rare events, but far more realistic than ALS or MS when it comes to BFS like symptoms