Share your insights

Help us by sharing what content you've recieved in your exams


Cauda Equina Syndrome

Definition:
  • A serious neurological condition due to compression of the cauda equina nerve roots (located at the lower end of the spinal cord).
Cauda Equina Syndrome
Etiology:
  • Lumbar disc herniation (most common).
  • Spinal tumours.
  • Spinal stenosis.
  • Trauma, e.g., fractures.
  • Infectious conditions, e.g., abscess.
  • Spinal haemorrhage or haematoma.
  • Iatrogenic causes, e.g., post-operative complications.
Clinical Presentation:
  • Severe lower back pain.
  • Bilateral sciatica.
  • Lower limb weakness and/or numbness.
  • Saddle anaesthesia: numbness around the buttocks, perineum, and inner surfaces of the thighs.
  • Bladder and bowel dysfunction (retention, incontinence).
  • Sexual dysfunction.
  • Loss of reflexes in the lower extremities.
Investigations:
  • Urgent MRI spine: Gold standard to identify the cause of compression.
  • Clinical examination: Assess tone, power, reflexes, and sensation in lower limbs. Assess perianal sensation and tone.
  • Urinalysis: To rule out urinary retention and infection.
Management:
  • Immediate surgical decompression: To prevent permanent neurological damage. Ideally within 48 hours of symptom onset.
  • High dose corticosteroids: Controversial, but sometimes given pre-operatively.
  • Bladder catheterisation: If there’s urinary retention.
  • Physiotherapy and rehabilitation post-operatively.
Prognosis:
  • Varies depending on the duration of compression before treatment and severity of symptoms. Earlier treatment typically results in a better prognosis.
Complications:
  • Persistent bladder, bowel, and sexual dysfunction.
  • Chronic pain.
  • Permanent motor and sensory deficits.

No comments yet πŸ˜‰

Comments are closed for this post.