Conus medullaris presentation includes which features?

• A. Bowel, bladder, and sexual dysfunction, sensory loss, uncontrolled bladder
• B. Pure motor weakness
• C. Loss of vibration only
• D. Hyperreflexia in legs

Answer: (A)

Conus medullaris syndrome results from injury to the sacral nerve roots at the end of the spinal cord, so autonomic and saddle-area functions are affected early. The hallmark is loss of perineal sensation with bowel and bladder dysfunction and often sexual dysfunction, reflecting sacral (S2–S4) involvement. Leg weakness is typically mild or nonprogressive, so the autonomic and sensory signs dominate rather than pure motor loss. This pattern distinguishes it from other options that emphasize isolated motor weakness, loss of a single sensation like vibration, or prominent leg reflex changes.