Cauda Equina Syndrome (CES)
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The most common cause of Cauda Equina Syndrome results from a prolapsed
disc pressing on the bundle of nerve roots at the base of the spinal
column.
Delay in treatment can cause irreparable damage and it is
incumbent on treating physicians to ensure that they are familiar with
the 'red flag' signs of this condition and ensure surgical intervention
by a competent neurosurgeon at the first possible opportunity.
The
Cauda Equina, which is Latin for 'horses tail', is the bundle of nerve
fibres at the base of the spinal column which radiate out to the legs
and lower areas of the abdomen and control movement and feeling.
Pressure on this bundle of nerves causes distinctive symptoms including
pain, sensory loss in the sacral region, weakness in the legs and loss
of bladder control which can be confirmed by diagnostic techniques
including MRI scan, Myelography and CAT scans.
This condition
is frequently referred to as rare however prolapsed disc problems are
very common and about 2% of lumbar disc protrusions result in pressure
on these nerves.
The surgical treatment of an acute nerve
compression is usually regarded as a medical emergency due to the
potential for serious damage and consequences to the victim if
treatment is delayed.
Major symptoms of this condition may include
- Localised low back pain with tenderness to applied pressure
- Abnormal reflexes which typically include loss or diminution of reflexes
- Pain in the legs or radiating to the legs
- Loss or reduction of sensation in the 'saddle' area which may show skin breakdown
- Muscle weakness or muscle wasting if CES has been present for a lengthy period
- Incontinence
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