Which of the following is not a feature of Conus Syndrome

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 1^st 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