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Tethered cord syndrome
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== Signs and Symptoms == [[File:Tethered cord symptoms (Part II).jpg|thumb|Chiari Neurological Center’s tethered cord questionnaire (Part I)]][[File:Tethered cord symptoms (Part I).jpg|thumb|Chiari Neurological Center’s tethered cord questionnaire (Part II)]] Symptoms<ref name=":4" /><ref name=":0">{{Cite journal | last =Wilberger | first=James E. | last2 = Pang | first2 = Dachling | date = 1982-07-01 | title = Tethered cord syndrome in adults|url=https://thejns.org/view/journals/j-neurosurg/57/1/article-p32.xml|journal=Journal of Neurosurgery|language=en-US|volume=57|issue=1|pages=32–47|doi=10.3171/jns.1982.57.1.0032}}</ref><ref name=":1">{{Cite web|url=https://www.seattlechildrens.org/conditions/brain-nervous-system-mental-conditions/tethered-spinal-cord/ | title = Tethered Spinal Cord|website=Seattle Children’s Hospital|language=en|access-date=2019-06-02}}</ref><ref>{{Cite journal | last =Gupta | first = S. K | last2 = Khosla | first2=V. K | last3 = Sharma | first3=B. S | last4 = Mathuriya | first4 = S. N| last5 = Pathak | first5 = A | last6 = Tewari | first6 = M. K | date = 1999-10-01 | title = Tethered cord syndrome in adults|url=http://www.sciencedirect.com/science/article/pii/S0090301999001214|journal=Surgical Neurology|volume=52|issue=4|pages=362–370|doi=10.1016/S0090-3019(99)00121-4|issn=0090-3019}}</ref><ref>{{Cite web|url=https://www.hindawi.com/journals/crior/2015/926185/ | title = An Unusual Presentation of Adult Tethered Cord Syndrome Associated with Severe Chest and Upper Back Pain | last =Saita | first = Kazuo | last2 = Yamaguchi | first2 = Takehiko | date = 2015 | website = Case Reports in Orthopedics|language=en|access-date=2019-06-02 | last3 = Chikuda | first3=Hirotaka | last4 = Akiyama | first4 = Toru | last5 = Kanda | first5 = Shotaro}}</ref><ref name=":5">{{Cite web|url=https://www.aans.org/ | title = Tethered Spinal Cord Syndrome – Causes, Diagnosis and Treatments|website=aans.org|language=en|access-date=2019-06-02}}</ref><ref>{{Citation | title = 2019 ASAP Conference: Tethered Cord Syndrome, P Klinge, MD, PhD|url=https://www.youtube.com/watch?v=zpSXSMPiMI8|language=en|access-date=2021-08-11}}</ref> of tethered cord syndrome ''may ''include: * Leg pain (often migratory/traveling), weakness, and/or numbness * Neck pain * Suboccipital pain/pressure * Lower back pain * Pulling sensation (on brain or upper spine, from below) * Neck or spine stiffness * Restless legs * Rectal pain * Urinary urgency or incontinence * Frequent urination (*most people urinate 6-7 times in a 24 hour period) * Urinary retention / difficulty emptying bladder completely * Bowel dysfunction * Constipation * Numbness under soles of feet * Falling/tripping/clumsiness * Decreased sensation or and/or hypersensitivity in feet * Decreased sensation and/or hypersensitivity in genitals * Decreased interest in sex * Difficulty maintaining arousal or achieving orgasm * Seizure * Tinnitus Signs of tethered cord syndrome ''may ''include: * Sacral dimple (see 10A.2) * Birthmark, hole in skin, or tuft of hair in lumbar area * Scoliosis * Kyphosis * Hip/knee subluxations * Sacral pain * Foot/ankle deformities * Asymmetry in neurological deficits * Hyperreflexia/clonus * Tremors * Light touch deficit * Curling toes Symptoms tend to increase when: * Walking or running * Walking on heels * Walking up stairs * Laying completely flat Symptoms tend to decrease when: * Walking on toes * Laying with knees bent * Avoiding walking long distances * Avoiding standing still Childhood indictors (relevant for children as well as adults who may have mild and largely assymptomatic prior to illness onset): * Cutaneous signs at birth, e.g., sacral dimple, birth mark, hole, tuft of hair in lumbar area * Late bedwetting * Growing pains * Walking on toes as a child (and/or prefering high heels or wedge shoes as an adult) * Difficulty running * ”Clumsiness” * Thoracic kyphosis (hunched shoulders) after puberty/with growth in height * Scoliosis Other possible indicators: * Frequent urinary tract infections * Interstitial cystisis * Pelvic floor dysfunction *
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