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Updated: Nov 2, 2025

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[Epiconus Syndrome and Conus Syndrome].

Takashi Kameyama1, Tetsuo Ando

  • 1Department of Neurology, Chubu Rosai Hospital.

Brain and Nerve = Shinkei Kenkyu No Shinpo
|June 15, 2021
PubMed
Summary

Epiconus and conus syndromes affect the spinal cord

Area of Science:

  • Neuroscience
  • Anatomy
  • Clinical Neurology

Background:

  • The caudal spinal cord comprises the epiconus (L4-S2) and conus medullaris (S3-S5), with associated nerve roots.
  • Lesions at the thoracolumbar junction can result in epiconus or conus syndrome.
  • Ossification of the ligamentum flavum is a notable cause of epiconus syndrome.

Purpose of the Study:

  • To elucidate the distinct anatomical characteristics of the caudal spinal cord.
  • To differentiate between epiconus and conus syndromes.
  • To emphasize the importance of understanding these syndromes for accurate diagnosis.

Main Methods:

  • Review of anatomical features of the caudal spinal cord.
  • Analysis of clinical presentations of epiconus and conus syndromes.

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  • Comparison with differential diagnoses like lumbar radiculopathy and cauda equina lesions.

    • Main Results:

    • Epiconus syndrome presents with lower extremity weakness, atrophy, and potential foot drop, mimicking motor neuron disease.
    • Conus syndrome involves urinary/rectal dysfunction, with accompanying lower extremity motor and sensory deficits.
    • Both syndromes are frequently misdiagnosed.

    Conclusions:

    • Accurate diagnosis requires a deep understanding of the anatomical substrates and pathophysiology of epiconus and conus syndromes.
    • Early and precise diagnosis is crucial for effective patient management.
    • Distinguishing these syndromes from lumbar radiculopathy and cauda equina lesions is clinically significant.