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Old 07-07-2014
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Default Conus medullaris syndrome help

So the conus medullaris ends at the lower border of L1. The question is, why is it that the conus medullaris syndrome involve cord segments way below where it ends (between S3 to C0)?
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Old 07-07-2014
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from what i understand conus medullaris does not involve deficits lower than the lesion..while a lesion of the caudal equina does....?

in retrospect, conus medullaris syndrome and caudal equina syndrome both involve urinary and fecal incontinence ( lesions lower than that level as you mentioned) however, only caudal equina syndrome has lower limb involvement....

Last edited by USMLEgen; 07-07-2014 at 05:00 PM. Reason: added more info
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Old 07-07-2014
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Well if the cauda equina is damaged the incontinence is unremarkable however, there is severely impaired incontinence in conus medullaris syndrome.

I still don't get it! I guess I just have to learn it as it is. Thanks for your response mate
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Old 07-08-2014
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No worries! You're question has prompted me to do a little more digging...and according to HY Neuroanatomy:

Conus Medullaris Syndrome S3-C0)
Bilateral, severe uninary incontinence & sexual disfunction, BILATERAL loss of sensation ( saddle-shaped), no notable muscle defects, sudden onset

Cauda Equina ( L3-C0)
- unremarkable urinary incontinence and sexual functions, UNILATERAL loss of sensation ( saddle shaped), and muscle atrophy, gradual onset

maybe because the lesion in CMS = bilateral deficits, the deficits are seen in lower levels..ie. more severe?

anyways...couldnt find anything more, sorry! GL
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eizou (07-08-2014)



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