2001 Volume 7 Issue 1 Pages 120-125
Epiconus syndrome presents complex features, including muscle atrophy, hypo-reflexia and several kind of sensory disturbance. Of 37 patients who were treated for spine and spinal cord diseases at thoracolumbar junction, 8 patients, 5 men and 3 women, aged 14 to 81 years, demonstrated the epiconus syndrome. We evaluated each patient for clinical symptoms, including the determination of the level of spinal cord involvement affecting their neurological features. All patients presented uni- or bilateral muscle atrophy as well as sensory deficit. The patellar and Achilles tendon reflex were hypoactive in 6 patient, while pathological reflexes were seen in 2 cases and bladder dysfunction were seen in 6 cases. Three patients were initially misdiagnosed. Epiconus syndrome with radicular sensory disturbance is often missed, because its neurological symptoms are analogous to peripheral neuropathies, such as lumbar radiculopathy and peroneal nerve palsy. The level of spinal cord termination was between the middle third of T12 and the lower third of L3, but most frequency at the L1 vertebra. The presence of different neurological features related to epiconus compromise should be carefully examined with reference to the level of the spinal cord.
