Konus Syndrome

The cone syndrome is caused by pressure on the lower part of the spinal cord . This can lead to numbness on the inside of the thighs, incontinence and disorders of sexual function.

Emergence

The syndrome is caused by damage to the lower (caudal) spinal cord, the end of which tapers off as the conus medullaris . The sacral spinal cord segments S3 to S5 as well as coccygeal (Co) segments are affected, which in humans lie at the level of the lumbar vertebrae after birth . Possible causes are medial herniated discs in this area, circulatory disorders or tumors . The conus medullaris can also inbornly adhere to surrounding structures ( tethered cord syndrome ) in such a way that it is damaged as it grows. The cone syndrome rarely occurs alone, but mostly in combination with the Kauda syndrome . Then one speaks of a cone-cauda equina syndrome .

Symptoms

A so-called breeches anesthesia shows up relatively early in the course , in which sensory disturbances occur in the skin area behind the inside of the thighs and around the anus. This area corresponds to the skin area supplied by the nerves S3 to S5 ( dermatome ). The bowel movements can no longer be controlled. The urine keeps dripping. Nevertheless, the bladder remains filled and it is difficult to urinate voluntarily ( overflow incontinence ). Erectile dysfunction and ejaculation disorders are found in men . Pain can be moderate in the hip region. There is no paralysis in the legs.

Diagnosis

The anus is slack because the sphincter muscle has failed. The anal and bulbocavernosus reflex are weakened or have failed. In isolated cone syndrome, the patellar and Achilles tendon reflexes are preserved. A CT scan or an MRI can help determine the cause.

therapy

Konus syndrome is a medical emergency. The cause must be eliminated quickly to avoid irreversible damage. Surgical intervention is usually required.

Individual evidence

^ Cone and Kauda Syndrome. In: KF Masuhr, M. Neumann: Neurology. (= Dual row). 6th edition. Thieme, Stuttgart 2007, ISBN 978-3-13-135946-9 , 2007, p. 121.
↑ Clinical differentiation between cone and cauda equina syndrome. In: H. Grehl, F. Reinhardt: Checklist Neurology. 4th edition. Thieme, Stuttgart 2008, ISBN 978-3-13-126274-5 , p. 211.
↑ Motor system. In: M. Bähr, M. Frotscher: Duus' Neurologische-Topologische Diagnostik. 8., completely revised. Edition. Thieme, Stuttgart 2003, ISBN 3-13-535808-9 , p. 85.

[1] Cone and Kauda Syndrome. In: KF Masuhr, M. Neumann: Neurology. (= Dual row). 6th edition. Thieme, Stuttgart 2007, ISBN 978-3-13-135946-9 , 2007, p. 121.

[2] Clinical differentiation between cone and cauda equina syndrome. In: H. Grehl, F. Reinhardt: Checklist Neurology. 4th edition. Thieme, Stuttgart 2008, ISBN 978-3-13-126274-5 , p. 211.

[3] Motor system. In: M. Bähr, M. Frotscher: Duus' Neurologische-Topologische Diagnostik. 8., completely revised. Edition. Thieme, Stuttgart 2003, ISBN 3-13-535808-9 , p. 85.