Epiconus, Conus and Cauda Equina syndromes

Epiconus Syndrome:

The epiconus syndrome presents with the following clinical features.

A sensory disturbance in the leg (transverse, saddle, radicular, or socks type).

Motor deficit as a sign of lower motor neuron involvement (foot drop, fasciculation, muscle atrophy).

Diminished deep tendon reflexes.

Occasional coexistence of positive pathological reflexes (Babinski's and Chaddock's signs).

Diminished vibration sensation, and

Bladder and bowel dysfunction.

Conus Medullaris Syndrome:

Mixed LMN and UMN type of picture seen

During the Acute phase paralysis of lower extremities with flaccid rectal tone and urinary retention are found.

In chronic phase there is evidence of atrophy and hyperreflexia.

The defecits tend to be symmetrical.

The prognosis for bowel and bladder function is relatively poor.

In pure Conus medullaris syndrome as in Intramedullary lesions there is total absence of motor disturbances inlower limbs and absent Babinski and other pathological pyramidal tract signs

CaudaEquina Syndrome:

Early radicular type of pain, Late sphincter disturbances,  and Asymmetrical sensory findings are characteristics.

Pain is unilateral or asymmetrical 

Develops flaccid, Hypotonic, areflexic paralysis true peripheral type of paraplegia.

Asymmetric sensory loss in saddle region involving anal, perineal and genital regions.

Ankle jerk is absent and has variable Knee jerk