Symptoms may be slow to appear and may vary in their intensity. A person should see his or her doctor if he or she has: Lost the ability to control his or her bladder or bowels. Less or changed sensation between the legs or over the buttocks, the inner thighs, the back of the legs, the feet or the heels.
Red flag symptoms of cauda equina syndrome
Pins and needles/reduced sensation in the perineum, buttocks and upper legs (known collectively as the 'saddle' area) Neurological deficit in the lower limbs, with difficulty walking, foot drop and reduced reflexes.
Elsberg syndrome is a rare infectious syndrome that mimics cauda equina syndrome. 3 It is an acute, bilateral lumbosacral myeloradiculitis, which characteristically occurs secondary to herpes virus infection. Most commonly, HSV-2 is the causative pathogen, but VZV is also a well-recognised aetiological agent.
Introduction. Cauda equina syndrome (CES) is a surgical emergency caused by a compression of the cauda equina. If untreated, patients can develop debilitating complications, hence a high level of suspicion and rapid intervention is required. The condition has peak onset between 40-50 years of age.
Sharp or stabbing pain in the legs or lower extremities
Compression of the cauda equina may lead to sciatic nerve pain felt on both sides of the body, and may be experienced as a sharp, hot pain felt down the backs of the thighs and possibly into the lower legs and feet.
Can you walk with cauda equina syndrome? Most people are able to walk with cauda equina syndrome. Early signs of the syndrome can include changes in bowel and bladder function, a loss of feeling in the groin area and leg pain.
The pain can range from mild to severe. Sciatica on both sides can be a sign of cauda equina syndrome, which is a medical emergency.
You should also be aware that symptoms can either develop rapidly within 24 hours, or gradually progress over weeks or months. During this period, cauda equina symptoms can come and go.
Early symptoms of cauda equina syndrome can include: Lower limb weakness and intermittent changes in sensation, such as numbness. “Saddle anesthesia” – loss or diminished sensation in areas where a person would sit on a saddle. Urinary and/or bowel problems, such as retention or incontinence.
Cauda equina syndrome can cause a variety of symptoms, including: severe low back pain. bladder dysfunction such as urinary retention or incontinence (loss of control) bowel incontinence (loss of control)
Reflex tests of the lower limbs; A genital examination to check for loss of sensation in the perineum, buttocks and genitals; A digital rectal examination to check for the loss of anal tone; Locating the pain in the back and leg(s) to check if it corresponds with the sciatic nerve.
Approximately 75% of patients sent for an MRI scan with suspected cauda equina syndrome will have a negative result. In other words, they do not have cauda equina syndrome. In such cases medical practitioners can rule out nerve compression and must consider an alternative diagnosis.
It shares some of the same symptoms as sciatica, but there are some big red flags that indicate CES rather than sciatica: Severe back pain. Saddle anesthesia. Bowel or bladder incontinence or retention.
Cauda equina syndrome (CES) results from compression and disruption of the function of these nerves and can be inclusive of the conus medullaris or distal to it, and most often occurs when damage occurs to the L3-L5 nerve roots.
In the earlier stages, cauda equina syndrome may cause pain and numbness in one or both legs. Symptoms can develop over progressively, and symptoms may come and go over the course of several weeks or months.
Gradual onset CES occurs when compression of the cauda equina nerve takes place over a period of weeks, months or even years. During this time, the patient may experience chronic, recurrent back pain accompanied by signs and symptoms of sensory deficit, motor weakness, and bowel and bladder dysfunction.
Severe symptoms start suddenly. You'll likely need surgery within 24 to 48 hours. This name means long-lasting cauda equina syndrome.
Since one of the factors that can bring on cauda equina is long-term compression, is it possible to not know that you're living with it? Well, yes and no. You'll likely be aware of the symptoms of another spinal condition that crowds the spinal canal before cauda equina syndrome materializes.
The diagnosis of Cauda Equina Syndrome is not very difficult. Some diagnostic imaging techniques like x-ray, CT scan, and MRI can reveal the issue.
Symptoms and Signs
Spinal cord compression is more likely to be thoracic with neurology in the upper limbs with bladder & bowel changes being a very late sign. Whereas in cauda equina, the lower limbs are classically affected with earlier bladder & bowel dysfunction and saddle anaesthesia.