Symptoms and Signs of Conus Medullaris and Cauda Equina Syndromes
| Conus Medullaris Syndrome | Cauda Equina Syndrome | |
| Presentation | Sudden and bilateral | Gradual and unilateral |
| Reflexes | Knee jerks preserved but ankle jerks affected | Both ankle and knee jerks affected |
| Radicular pain | Less severe | More severe |
| Low back pain | More | Less |
| Sensory symptoms and signs | Numbness tends to be more localized to perianal area; symmetrical and bilateral; sensory dissociation occurs | Numbness tends to be more localized to saddle area; asymmetrical, may be unilateral; no sensory dissociation; loss of sensation in specific dermatomes in lower extremities with numbness and paresthesia; possible numbness in pubic area, including glans penis or clitoris |
| Motor strength | Typically symmetric, hyperreflexic distal paresis of lower limbs that is less marked; fasciculations may be present | Asymmetric areflexic paraplegia that is more marked; fasciculations rare; atrophy more common |
| Impotence | Frequent | Less frequent; erectile dysfunction that includes inability to have erection, inability to maintain erection, lack of sensation in pubic area (including glans penis or clitoris), and inability to ejaculate |
| Sphincter dysfunction | Urinary retention and atonic anal sphincter cause overflow urinary incontinence and fecal incontinence; tend to present early in course of disease | Urinary retention; tends to present late in course of diseas |