Template:Epidural compression syndromes clinical: Difference between revisions

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===[[Epidural compression syndromes]] table===
===[[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'''
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| align="center" style="background:#f0f0f0;"|'''[[Cauda equina syndrome]]'''
| align="center" style="background:#f0f0f0;"|'''[[Cauda equina syndrome]]'''
|-
|-
| Lesion||Back pain with neuro deficits||Lesions at vertebral level L2||Low Back Pain
| '''Location of lesion'''||||Lesions at vertebral level L2||
|-
|-
| ||Weakness in lower extremities, paresthesias/sensory deficits, gait difficultly||Early and prominent sphincter dysfunction with flaccid paralysis of the bladder and rectum, impotence, and saddle (S3-S5) anesthesia||Urinary retention with or without overflow incontinence (Sn 90%, Sp 95%)
| '''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||||Rectal incontinence
| '''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
|-
|-
| ||Bladder and rectal sphincter paralysis usually reflect involvement of S3-S5 nerve roots||||Bilateral sciatica
| '''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
|-
|-
| ||||||Saddle anesthesia (75% pts)
| '''[[Reflexes|Reflex]] changes'''||||Achilles reflex may be absent||Patellar and Achilles reflexes may be absent
|-
|-
| ||||||Decreased anal sphincter tone (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)
|-
|-
| ||||||Difficulty ambulating and/or wew foot-drop
| '''Male sexual function'''||||Impaired early||Impairment less severe
|-
|-
| ||||||Symptoms worsened by coughing (increases intraspinal pressure)
| '''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%)
  1. Bradley WG. Neurology in Clinical Practice: Principles of diagnosis and management. P363