Cauda Equina Syndrome (CES) & Conus Medullaris Syndrome (CMS)

Feature

Cauda Equina Syndrome (CES)

Conus Medullaris Syndrome (CMS)

Location

Injury to the nerve roots of the cauda equina (below L2).

Lesion at the conus medullaris (L1-L2 level).

Nature of lesion

Peripheral nerve (lower motor neuron) lesion.

Mixed lesion: both upper and lower motor neuron signs.

Weakness

Asymmetric in legs.

Symmetric, mild in legs.

Anal Sphincter Tone

Normal early, lost late.

Decreased early.

Bladder/Bowel Issues

Develop late.

Appear early.

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