Cauda Equina Syndrome (CES) is a medical emergency that requires immediate diagnosis and emergency treatment. This should be possible in the majority of cases, as the condition is a mainstream problem that has a number of characteristic symptoms. Therefore if doctors fail to recognise the signs indicative of nerve compression and a patient suffers as a result, there could be a case of medical negligence.
Urgent Diagnosis and Emergency Treatment for CES
At the bottom of the spinal canal are a bundle of nerve roots that enable the lower limbs, sexual organs and perineum to move and/or to feel sensation. Should these nerves become compressed for any reason – for example, because of a prolapsed disc or a spinal lesion – someone is said to have Cauda Equina Syndrome. This is associated with particular symptoms, including leg and back pain, loss of sexual function and loss of rectal tone and altered bladder function. The latter is the most telling indication of CES, with a loss of desire to void, altered urethral sensation and the need to strain all telling signs that the lower spinal nerves are being compressed.
If someone presents to an Accident and Emergency department with these symptoms, doctors should quickly recognise them as the tell-tale signs of cauda equina syndrome. A physical examination to test rectal tone, motor weakness and perineal sensation should then be performed. If the findings of this examination correspond with a putative diagnosis of CES, no time should be wasted in arranging an MRI scan. This should be considered a matter of urgency, meaning there should not be a delay or more than a few hours. If the scan reveals that the cauda equina nerves are indeed being compressed, emergency decompression surgery should be carried out at the earliest opportunity.
Failure To Diagnose and Treat Cauda Equina Syndrome
As long as action is taken quickly by medical professionals, it is very possible that the nerves will be decompressed before too much damage is sustained. This is of the utmost important, as Cauda Equina Syndrome is a very serious medical problem which will give rise to significant long term handicap if untreated. However, there is only a short timeframe in which treatment will prove to be successful, as it is generally accepted that irreparable nerve damage will arise within 48 hours of the onset of symptoms.
Therefore if medical professionals fail to recognise the clinical signs of spinal compression, subsequently causing a delay in diagnosis and treatment, the level of care will have fallen to a substandard level. If this results in a patient suffering permanent neurological injury (which would otherwise have been avoided with a timely diagnosis and treatment) there will be a case of medical negligence. The victim of this negligence will be legally entitled to pursue a claim for compensation.