Template:Epidural compression syndromes clinical: Difference between revisions
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===[[Epidural compression syndromes]] table<ref>Bradley WG. Neurology in Clinical Practice: Principles of diagnosis and management. P363</ref>=== | |||
{| class="wikitable" | {| class="wikitable" | ||
| align="center" style="background:#f0f0f0;"|'''Syndrome''' | | align="center" style="background:#f0f0f0;"|'''Syndrome''' | ||
| Line 5: | 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|| | ||
|- | |- | ||
| || | | '''Spontaneous pain'''||||Unusual and not severe; bilateral and symmetrical in perineum or thighs||Often very prominent and severe, asymmetrical, radicular | ||
|- | |- | ||
| ||Deficits usually affect both legs but are often asymmetric|||| | | '''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 | ||
|- | |- | ||
| |||||| | | '''[[Reflexes|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%) | |||
|} | |} | ||
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