OCCULT FILUM TERMINALE SYNDROME

Thirty-two pediatric patients presenting with symptoms of urinary dysf unction, stool incontinence and/or severe back and/or leg pain are des cribed. In patients with urological dysfunction, urodynamic testing wa s consistent with a neurogenic etiology. Imaging studies demonstrated the tip of the conus medullaris to lie above the L2 vertebral body, an d the filum terminale to be of normal diameter (<2 mm) in all patients . A diagnosis of an occult filum terminale syndrome was made based on clinical presentation in the absence of associated imaging abnormaliti es and section of the filum terminale was performed. Postoperatively, the majority of patients (97%) experienced significant (>50%) relief o f their symptoms. The managment of these patients is discussed.