What can a medical practitioner do to speed up your cauda equina syndrome diagnosis?
To get a definitive diagnosis that a patient’s symptoms are being caused by compression of the cauda equina nerves, it is usually necessary for the patient to undergo an MRI scan. However, in order for a medical practitioner to consider if a patient is demonstrating the signs of cauda equina syndrome, there is a range of tests which could be undertaken.
Loss of sensation
One of the effects of cauda equina compression is the loss of sensation around the saddle area – that is, between the legs, around the anus and the genitals. The patient may not necessarily be fully aware of these losses but some simple tests may make it clear:
- Pin prick tests to the skin should identify whether the patient has sensation in the saddle area
- Asking the patient if they have awareness of feeling when they wipe themselves after emptying their bowels can identify
- Loss of feeling
- A catheter tug test, where appropriate, can also help to assess the level of feeling experienced by the patient. If the patient has been fitted with a catheter due to urinary problems assumed to have a physical cause, a gentle tug should indicate whether the patient has sensation in that area or whether their urinary difficulties may be due to loss of nerve function and feeling.
Muscle control
One of the effects of cauda equina syndrome is the loss of motor function in the lower body. A number of tests can flag up any issues with this that the patient might be experiencing:
- A digital rectal examination will assess the degree of anal tone and the patient’s ability to voluntarily contract the anal muscles. A reduced anal tone may suggest a loss of function of the cauda equina nerves
- An ankle reflex test can also be useful in identifying neurological losses. When a patient is suffering with cauda equina syndrome, they may lose the ability to flex their feet. If there is no response to an ankle reflex test or if the patient is clearly experiencing difficulty in flexing the foot, this may suggest a loss of nerve function.
Pain
Patients who are developing cauda equina syndrome usually present with severe lower back pain as well as pain radiating down one or both legs. A straight leg raising test can indicate where the cause of that pain may be sourced. If a patient lying on their back experiences pain when raising their leg to a limited degree, it may suggest problems with the cauda equina nerves.
Diagnosing cauda equina syndrome
Whilst red flag symptoms of cauda equina syndrome generally focus on urinary, bowel and sexual function, the above-mentioned tests can help to identify a patient who may need an urgent MRI referral.
A failure to act on symptoms of cauda equina compression can have a catastrophic effect on the patient and may be considered to have been medically negligent.
If you are suffering the appalling long-term effects of cauda equina syndrome due to a delay in your diagnosis, contact us to discuss your experience with a specialist medical negligence solicitor. You may be able to make a claim for compensation.