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The epiconus syndrome presenting with radicular-type neurological features
Y Toribatake1, H Baba, N Kawahara
1Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Japan.
Spinal Cord
|March 1, 1997
Summary
Epiconus syndrome, affecting the lower spinal cord, can cause leg atrophy and sensory loss. Accurate diagnosis requires correlating symptoms with the spinal cord termination level for effective treatment.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Epiconus syndrome presents with varied neurological deficits in the lower extremities.
- Accurate localization of the lesion is crucial for diagnosis and treatment planning.
Observation:
- Fifteen patients (10 male, 5 female; aged 37-71) with epiconus syndrome were studied.
- Common symptoms included unilateral/bilateral leg muscle atrophy, sensory deficit, and altered deep tendon reflexes.
- Bladder dysfunction and pathological reflexes were also observed in a subset of patients.
Findings:
- Radiological examination revealed epiconus compromise from T10 to T12-L1 disc levels, most commonly at T11-12.
- Spinal cord termination was most frequent at the L1 vertebra, averaging 1.6 vertebrae distal to the epiconus lesion.
- Five patients were initially misdiagnosed and surgically treated for other spinal conditions.
Implications:
- Understanding the relationship between epiconus lesion level and spinal cord termination is vital for accurate diagnosis.
- Careful neurological examination correlated with imaging findings can prevent misdiagnosis and inappropriate surgical interventions.
- This study highlights the importance of precise anatomical localization in managing epiconus syndrome.