| 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%)
|
