Template:Epidural compression syndromes clinical: Difference between revisions
| (One intermediate revision by one other user not shown) | |||
| Line 6: | Line 6: | ||
| align="center" style="background:#f0f0f0;"|'''[[Cauda equina syndrome]]''' | | align="center" style="background:#f0f0f0;"|'''[[Cauda equina syndrome]]''' | ||
|- | |- | ||
| Location of lesion||||Lesions at vertebral level L2|| | | '''Location of lesion'''||||Lesions at vertebral level L2|| | ||
|- | |- | ||
| Spontaneous pain||||Unusual and not severe; bilateral and symmetrical in perineum or thighs||Often very prominent and severe, asymmetrical, radicular | | '''Spontaneous pain'''||||Unusual and not severe; bilateral and symmetrical in perineum or thighs||Often very prominent and severe, asymmetrical, radicular | ||
|- | |- | ||
| Motor findings||Deficits usually affect both legs but are often asymmetric||Not severe, symmetrical; rarely twitches||May be severe, asymmetrical, fibrillary twitches of paralyzed muscles are common | | '''Motor findings'''||Deficits usually affect both legs but are often asymmetric||Not severe, symmetrical; rarely twitches||May be severe, asymmetrical, fibrillary twitches of paralyzed muscles are common | ||
|- | |- | ||
| Sensory findings||Weakness in lower extremities, paresthesias/sensory deficits, gait difficulty||Saddle distribution, bilateral, symmetrical, disassociated sensory loss (impaired pain and temperature with sparing of tactile)||Saddle distribution (75% pts), may be asymmetrical, no dissociation of sensory loss | | '''Sensory findings'''||Weakness in lower extremities, paresthesias/sensory deficits, gait difficulty||Saddle distribution, bilateral, symmetrical, disassociated sensory loss (impaired pain and temperature with sparing of tactile)||Saddle distribution (75% pts), may be asymmetrical, no dissociation of sensory loss | ||
|- | |- | ||
| [[Reflexes|Reflex]] changes||||Achilles reflex may be absent||Patellar and Achilles reflexes may be absent | | '''[[Reflexes|Reflex]] changes'''||||Achilles reflex may be absent||Patellar and Achilles reflexes may be absent | ||
|- | |- | ||
| Sphincter disturbance||Bladder and rectal sphincter paralysis usually reflect involvement of S3-S5 nerve roots||Early and marked (both urinary and fecal)||Late and less severe (60-80% pts) | | '''Sphincter disturbance'''||Bladder and rectal sphincter paralysis usually reflect the involvement of S3-S5 nerve roots||Early and marked (both urinary and fecal)||Late and less severe (60-80% pts) | ||
|- | |- | ||
| Male sexual function||||Impaired early||Impairment less severe | | '''Male sexual function'''||||Impaired early||Impairment less severe | ||
|- | |- | ||
| Onset||||Sudden and bilateral ||Gradual and unilateral | | '''Onset'''||||Sudden and bilateral ||Gradual and unilateral | ||
|- | |- | ||
| Other||||||Urinary retention with or without overflow incontinence (Sn 90%, Sp 95%) | | '''Other'''||||||Urinary retention with or without overflow incontinence (Sn 90%, Sp 95%) | ||
|} | |} | ||
Latest revision as of 04:16, 30 March 2023
Epidural compression syndromes table[1]
| Syndrome | Spinal cord compression | Conus medullaris syndrome | Cauda equina syndrome |
| Location of lesion | Lesions at vertebral level L2 | ||
| Spontaneous pain | Unusual and not severe; bilateral and symmetrical in perineum or thighs | Often very prominent and severe, asymmetrical, radicular | |
| Motor findings | Deficits usually affect both legs but are often asymmetric | Not severe, symmetrical; rarely twitches | May be severe, asymmetrical, fibrillary twitches of paralyzed muscles are common |
| Sensory findings | Weakness in lower extremities, paresthesias/sensory deficits, gait difficulty | Saddle distribution, bilateral, symmetrical, disassociated sensory loss (impaired pain and temperature with sparing of tactile) | Saddle distribution (75% pts), may be asymmetrical, no dissociation of sensory loss |
| Reflex changes | Achilles reflex may be absent | Patellar and Achilles reflexes may be absent | |
| Sphincter disturbance | Bladder and rectal sphincter paralysis usually reflect the involvement of S3-S5 nerve roots | Early and marked (both urinary and fecal) | Late and less severe (60-80% pts) |
| Male sexual function | Impaired early | Impairment less severe | |
| Onset | Sudden and bilateral | Gradual and unilateral | |
| Other | Urinary retention with or without overflow incontinence (Sn 90%, Sp 95%) |
- ↑ Bradley WG. Neurology in Clinical Practice: Principles of diagnosis and management. P363