How Should A GP Respond to the Symptoms of Cauda Equina Syndrome?

The appropriate response to symptoms which might indicate cauda equina syndrome depends on the nature and severity of those symptoms. It might be appropriate simply to advise the patient of the red flag symptoms to look out for or an emergency referral to hospital might be necessary.

Pain symptoms

If the patient attends the GP with pain in the lower back and one or both legs, the GP should ideally carry out an examination to check for any other possible signs of cauda equina syndrome. This might involve pin-prick tests to identify any loss of sensation in the saddle area or a digital rectal examination to assess anal tone. The GP should also ask the patient about their bladder and bowel sensation.

The GP might refer the patient for an urgent MRI scan or, if they do not find signs which warrant this, they should warn the patient of the red flag symptoms to look out for and the need to attend A&E immediately should those symptoms start to develop.

Loss of sensation

If the patient is also starting to lose sensation in the saddle area and around the anus, the GP should also ask about their bladder symptoms. If the patient is starting to experience unusual bladder symptoms such as having to strain, or is losing awareness of needing to urinate, an emergency referral for an immediate MRI scan is probably necessary. An MRI scan should confirm the underlying cause of the patient’s symptoms and may indicate that the patient needs immediate surgery.

If the GP fails to make such a referral and the patient’s symptoms deteriorate still further, the GP may be considered to have acted negligently.

Incontinence

If the patient is already suffering episodes of urinary and possibly bowel incontinence, it may be that the best moment for surgery has already passed. Surgery to decompress the cauda equina nerves is probably still necessary as a matter of urgency in order to give the patient the best chance of some neurological recovery but it would seem that recovery is less likely at this point. Nonetheless, a referral for an urgent or immediate MRI scan is probably still necessary.

Speak to a solicitor

If you or a loved one are suffering the long-term, debilitating symptoms of cauda equina syndrome due to a delay in diagnosis, contact us to discuss your experience with a specialist medical negligence solicitor.

It may be appropriate to make a claim for compensation.

Please call us free on 0800 234 3300, from a mobile click to call 01275 334030 or complete our Free Online Enquiry for a no cost, no obligation opinion.

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