Tuesday, May 16, 2017

Difference between cauda equina syndrome and conus medullaris (with mnemonics)

Let's differentiate Cauda equina syndrome (CES) from conus medullaris today!
With mnemonics because they make life easier! (And because it is the IkaN style of doing things)

Conus medullaris is a part of this conical structure called the spinal cord. If the conus medullaris is damaged, UMN type of lesion will occur - with hyperreflexia.
Mnemonic: Conus - Cone of spinal cord - UMN signs

Cauda equina are nerves that exit the spinal cord. If the cauda equina is damaged, LMN type of lesion will occur - with hyporeflexia or areflexia
Mnemonic: Cauda equina is the lower part of the spinal cord - LMN signs

In conus medullaris, perianal hypo/anaesthesia occurs.
In cauda equina syndrome, saddle hypo/anaesthesia occurs.
Mnemonic: Conus rhymes with anus for perianal anaesthesia.

Cauda equina syndrome is usually asymmetric.
Conus medullaris is symmetric.
Mnemonic: cAudA has A's for Asymmetric involvement.

Conus medullaris has early onset of bowel and bladder involvement.
CES has late onset bladder involvement.
Mnemonic: Conus gives an early Bonus (Bowel and Bladder)

Conus medullaris - Sudden and bilateral
CES - Gradual and unilateral
Mnemonic: Conus Bilateral Bonus!

Conus medullaris has low back pain. Radicular pain is absent.
CES back pain is less severe. Radicular pain is present in CES.
Mnemonic: medulla has two L's for low back pain.

Conus medullaris frequently causes impotence.
In CES, impotence is absent.
Mnemonic: Conus involves a conical structure (If you know what I mean ;) )
Or conus bonus of no boner. (I should stop now.)

That's all!
I have been meaning to write this post forever and I could never find the time to organize myself and do it. I was planning to make a nice table for this post, but I think I should just publish it and go to sleep! Maybe I'll do it later when I am free :D


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