Both of these are orthopedic/neurosurgical emergencies! But in general, CM syndrome is more severe than CE syndrome.
Here's a comparison between the two...
|
Conus medullaris syndrome |
Cauda equina syndrome |
|
→
bilateral |
→
unilateral
or bilateral |
Motor |
→
symmetrical
weakness |
→
asymmetrical most often |
Sensory |
→
symmetrical
numbness 'Perianal anesthesia' common |
→
asymmetrical most often →
‘Saddle
anesthesia’ common |
Reflexes |
→
at
the level: HYPOreflexia →
below
the level: HYPERreflexia |
→
HYPOreflexia |
Impotence |
→ common |
→
rare |
Sphincter dysfunction |
→
EARLY
→
Both,
urinary and fecal incontinence |
→
LATE
→
urinary
retention only |
Radicular pain |
→
absent |
→
present |
Back pain |
→
more |
→
less
|
*Cauda equina includes L2 to Coccygeal-1 pair of spinal nerves.
*The nucleus of Onuf (or Onufrowicz) is a small group of neurons in the ventral horn of the S2 (and S3 too according to some authors) segment of the spinal cord. These are motor neurons that supply the external urethral & anal sphincters; also the levator ani and perineal (bulbospongiosus & ischiocavernosus [erector clitoridis in females]) muscles.
PS: I have skipped the anatomical details from the diagram like the dorsal & ventral roots of the spinal nerves, etc. for the purpose of simplicity of concept. :)
[- Dr. Suneet Patel
Happy studying, peeps! :)]
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