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Identifier: diseasesofnervou00gord (find matches)
Title: Diseases of the nervous system : for the general practitioner and student
Year: 1913 (1910s)
Authors: Gordon, Alfred, 1869-1953
Subjects: Nervous System Diseases
Publisher: Philadelphia : Blakiston's Son
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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eases of the conus. The symptoms therefore are (Figs. 97a, 97, 98):1. Anaesthesia or sensory dissociation of the external genital organs,perineum, anus, inferior gluteal region and the postero-superior area ofthe thighs (saddle-shaped anaesthesia). It may also extend to the mucousmembrane of the genito-urinary apparatus. The tenderness of the tes-ticles is intact. \ 2. Paralysis of the bladder and rectum. There may be incontinenceor retention. 3. Involvement of the sexual function and of the sensation ofejaculation. DISEASES OF CONUS MEDULLARIS 293 4. Pain is a frequent but not constant phenomenon. If it is present,it may be of great severity. As to the motor power of the lower extrem-ities it is normal. The reflexes are equally unaffected. The onset of these symptoms is sudden in traumatic cases, slow in casesof tumors. As the conus is immediately surrounded by the nerve bundles(cauda equina), a lesion of one is bound to involve the other and the symp-tomatology therefore is complex.
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Fig. 97.—Solid Portion, Analgesia. Cauda Equina.—If a tumor is situated below the conus, the main symp-toms will be those of involvement of the roots, viz. pain and objectivesensory disturbances. The pain is intense in the lumbo-sacral regionand in the limbs, chiefly in the region of both sciatic nerves; it is constantand increased upon the slightest movement. The objective sensory dis-turbances may be only anaesthesia. They occupy the lower extremitiesbeginning from the lower two-thirds of the thighs downward, the perineum,anus and the genito-urinary organs. There is anaesthesia of the mucous 294 DISEASES OF CONUS MEDULLARIS membranes of the urethra, bladder, vulva, vagina. The paralysis isflaccid at the beginning and during the entire course of the diesase.There is a high-steppage gait. Muscular atrophy appears early in thelower limbs. Reactions of degeneration are present. The reflexes Achilles,plantar and anal are abolished, but the knee-jerks are intact. Thesphincters are dis

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  • bookid:diseasesofnervou00gord
  • bookyear:1913
  • bookdecade:1910
  • bookcentury:1900
  • bookauthor:Gordon__Alfred__1869_1953
  • booksubject:Nervous_System_Diseases
  • bookpublisher:Philadelphia___Blakiston_s_Son
  • bookcontributor:Columbia_University_Libraries
  • booksponsor:Open_Knowledge_Commons
  • bookleafnumber:310
  • bookcollection:medicalheritagelibrary
  • bookcollection:ColumbiaUniversityLibraries
  • bookcollection:americana
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28 July 2014

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