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Can Cauda Equina Symptoms Come and Go?

Can Cauda Equina Symptoms Come and Go? Intermittent Cauda EquinaIf you are suffering from Cauda equina Syndrome, you may well want to know the answer to the question “Can cauda equina symstpoms come and go?”. The short answer is that cauda equina can develop very suddenly, or it can develop very gradually with symptoms appearing to come and go.

Acute onset of cauda equina syndrome

Generally speaking, cauda equina syndrome will either present as acute onset or gradual onset.

Acute onset cauda equina syndrome is when the condition occurs suddenly, with symptoms arising out of the blue and getting increasingly worse within a short time frame. Normally, the condition will be ‘complete’ within 48 hours of the onset of symptoms. When the condition is complete it means the nerves are irreparably harmed and cannot be restored. In these situations the question “Can cauda equina symptoms come and go?” is answered with a negative.

Gradual onset of cauda equina syndrome

Gradual onset cauda equina syndrome is when the condition occurs slowly, with symptoms getting progressively worse over a matter of weeks, months or even years. During this period, the symptoms of cauda equina syndrome may seem to come and go, with certain symptoms improving before deteriorating again.

A typical case study is a patient who seeks medical help for chronic lower back pain. He/she may then be given strong painkillers and may also be referred to a pain clinic. This may result in some improvement, only for the pain to return some time later, along with further symptoms such as paraesthesia (numbness/pins and needles) in the perineum.

Diagnosing gradual onset cauda equina syndrome

It may be difficult for doctors to diagnose gradual onset CES as it may initially mimic another condition, such as generalised lower back pain. Only when all the red flag symptoms of CES appear together will a clinician suspect cauda equina compression.

Nevertheless, a medical practitioner should keep a close eye on a patient whose condition is deteriorating, making sure to note any change in their symptoms. As soon as the red flag symptoms of cauda equina syndrome appear, immediate action should be taken to confirm or rule out a diagnosis. The investigation of choice is an emergency MRI scan, as this will reveal whether or not the nerves at the bottom of the spine are being compressed.

Failure to diagnose

If a patient’s cauda equina syndrome remains unnoticed, despite the fact he/she is displaying symptoms characteristic of spinal nerve compression, the standard of care will have fallen below an acceptable standard. If this delay in diagnosis causes a patient to suffer harm, there will be grounds for a clinical negligence claim.

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