Neurological Condition Cauda Equina Syndrome

Cauda equina syndrome is a neurological condition in which the nerves at the bottom of the spinal cord are compressed.

In order to diagnose cauda equina syndrome, doctors will need to carry out a neurological examination. This will reveal whether the patient has the clinical signs that are associated with cauda equina compression.

Neurological examination for cauda equina syndrome

It is recognised that the presentation of back pain plus bilateral leg pain and worsening symptoms suggest lumbar disc prolapse, requiring lumbar spine MRI scanning.

If a large central disc is found, and the patient is suffering symptoms suggestive of CES, a full neurological examination of the lower limbs and saddle area is necessary. This should be documented with negative as well as positive findings. The clinician should also review the MRI images and not simply rely on the radiology report.

The neurological assessment should look for signs of:

• Bilateral sciatica
• Sensory disturbance in the saddle area
• Autonomic dysfunction and sensory disturbance in the S2, S3 or S4 dermatomes – signified by numbness and paraesthesia (pins and needles) in the legs, buttocks, urinary tract, perineum and genitals
• Reduced anal tone

The patient may find this examination painful and embarrassing, but it is absolutely essential if the condition is to be diagnosed quickly. The patient should also be asked about their other symptoms, the presence of which are indicative of CES. These include:

• Low back pain
• Unilateral/bilateral sciatica
• Weakness in the lower limbs
• Bowel and bladder dysfunction
• Altered sexual sensation, particularly lack of sensation and erectile dysfunction

If the findings of the neurological assessment correlate with a diagnosis of cauda equina compression, and a disc prolapse can be seen on the MRI images, a patient should undergo immediate decompression surgery.

The omission of a full neurological assessment to confirm or exclude the signs of sacral root nerve compromise represents a breach of duty in care.

Breach of duty in care – what can you do?

If you have suffered because medical practitioners breached their duty of care towards you, you need to seek independent legal advice. Anyone who is harmed as a result of substandard medical care could be entitled to pursue a claim for compensation.

For more information on making a cauda equina syndrome compensation claim, please get in touch with our legal team today. We specialise in this area of the law and will be able to help you further.

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.

Share Article With: