Cauda equina syndrome is a fairly rare condition which many GPs may never encounter. Additionally, its main symptoms of leg pain and tingling, and urinary and sexual dysfunction are not unique to that condition. Consequently, this appalling condition is sometimes not diagnosed until it is too late.
Diagnosing cauda equina syndrome
There are several tests which GPs can carry out to assess a patient for cauda equina syndrome. These include straight leg raising, pin-prick tests to identify levels of sensation and a rectal examination to check for anal tone. However, the definitive test for cauda equina compression is an MRI scan.
Unfortunately, patients are often sent home with pain relief and no advice that, should their symptoms deteriorate, attendance at A&E becomes a matter of emergency.
The human cost
If cauda equina syndrome is diagnosed in its early stages, the patient can undergo decompression surgery and will have a good chance of a positive outcome with possible recovery of lost function.
If the early symptoms are not investigated, however, the patient may find that, by the time they have a confirmed and accurate diagnosis, surgery will make little difference to their long-term outcome.
If the early symptoms of cauda equina syndrome are misdiagnosed and the patient’s nerve compression deteriorates, they may be left with the following permanent effects:
- Urinary incontinence
- Bowel incontinence
- Sexual dysfunction
- Partial paralysis of both legs
The psychological impact of such life-changing symptoms can also be significant.
The financial cost
Long-term outcomes for patients with established cauda equina syndrome require significant changes in life-style:
- The patient may be unable to work and may therefore experience significant loss of income
- New, single-storey accommodation may be necessary to enable the patient to mobilise around the home
- The patient may require significant levels of personal care and support for everyday living
These needs and the right to compensation for the negligence in failing to diagnose their condition, leads many patients to seek legal advice and pursue a claim against the NHS Trust which treated them.
The urgency of diagnosis
A confirmed diagnosis that the patient’s symptoms are being caused by compression of the cauda equina nerves – and that the patient requires emergency surgery – requires an MRI scan.
This raises questions of cost and availability of equipment. Also, where patients only have very early symptoms of cauda equina syndrome, many may prove to have other causes.
However, as has been pointed out frequently, erring on the side of caution where cauda equina syndrome is suspected may be expensive but it may save many patients from a lifetime of dysfunction and misery.
Medical Negligence
If you are suffering the appalling symptoms of cauda equina syndrome due to a delayed diagnosis, you may wish to consider making a claim for compensation.
Glynns Solicitors is a specialist medical negligence legal practice with considerable expertise in cauda equina syndrome.
Contact us to discuss your experience.