Template:Epidural compression syndromes clinical

Epidural compression syndromes table

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 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%)