Question 79
Which of the following is not a feature of Conus Syndrome
a. Late Bladder involvement
b. Saddle Anaesthesia
c. Bilateral signs
d. Affects sacral segments
Answer
a. Late Bladder involvement
Reference
Textbook of Medicine : Vasan and Seshadhri 1st Edition Pages 463-465
QTDF
Textbook of Medicine :
Quality
Thinker
Status
Repeat
Discussion
Conus medullaris syndrome (CMS) and Cauda Equina Syndrome (CES) are complex neurological disorders that can be manifested through a variety of symptoms. Patients may present with back pain, unilateral or bilateral leg pain, paresthesias and weakness, perineum or saddle anesthesia, and rectal and/or urinary incontinence or dysfunction. Although patients typically present with acute disc herniations, traumatic injuries at the thoracolumbar junction at the terminal portion of the spinal cord and cauda equina are also common.
Explanation
Self Explanatory
Comments
Since this is a memory recollected paper, there was as considerable discussion regarding the choices. Few students were of the opinion that “Muscle Spasticity” “Involvement of Knee and Ankle Jerks” were also in the choices
Tips
| Conus Medullaris Syndrome | Cauda Equina Syndrome |
| More likely to present with bilateral signs since the conus is compact | More likely to be unilateral at onset |
| Isolated conus lesions cause no Lower Limb Weakness; if concomitant nerver root involvement occurs, L3 which lies close to the tip of the conus is most often affected – weak quadriceps L3 hyperalgesia | Typically, there is unilateral Lower Limb weakness involving feet and toes |
| Saddle anaesthesia seen early without weakness or anaesthesia elsewhere | Saddle anaesthesia seen late with bilateral lower Limb Weakness, sensory findings |
| Absent Anal reflex, bladder involvement Early | Rare, Late |
| Aching low back pain | Root pain radiating into legs |
