Clinical Features of Cauda Equina Syndrome

Cauda equina syndrome is characterised by a number of symptoms which together should enable medical professionals to make a timely diagnosis.

Presentation of cauda equina syndrome

1. Lower back pain

Cauda equina syndrome occurs when the bundle of nerves at the bottom of the spinal cord is compressed. At first, this will cause chronic lower back pain. If the sciatic nerve is also irritated, this pain will extend down into one leg (unilateral sciatica) or both legs (bi-lateral sciatica).

2. Urinary dysfunction

As the compression continues, the nerves will start to suffer harm and lose function. The first notable problem will be urinary dysfunction. A person may need to urinate more frequently but be unable to fully empty their bladder. He or she may need to strain in order to void and there may also be a loss of sensation while urinating.

3. Loss of saddle sensation

Along with the loss of sensation in the urethra, there will also be paraesthesia (numbness and tingling) in the saddle area. This refers to the perineum, genitalia and groin. Males may also notice erectile dysfunction.

4. Bowel dysfunction/loss of anal tone

Normally the next problem to ensue relates to the emptying of the bowels. Nerve compression will cause a loss of anal tone, which can in turn lead to episodes of faecal incontinence. Conversely, constipation is another classic symptom, although this is often caused by pain-relief medication taken for the chronic back pain.

Clinical diagnosis of cauda equina syndrome

The four symptoms described above are the main symptoms a patient with cauda equina syndrome will notice. When a patient presents to their GP or A&E department complaining of these physical problems, alarm bells should start ringing in the minds of medical professionals, as together these symptoms indicate the presence of cauda equina syndrome. Steps should then be taken to verify a clinical diagnosis, including:-

• Blood and urine tests to rule out other conditions such as a urinary tract infection;
• A digital rectal examination to check for loss of anal tone;
• Lower limb reflex tests to check for poor reflexes and weakness;
• A test to check for loss of sensation in the saddle area.

If these tests and examinations also point towards the possibility of cauda equina syndrome, an MRI scan should be organised without delay.

Doctors fail to recognise the clinical features of cauda equina syndrome

Unfortunately, however, there are times when doctors fail to recognise the clinical features of cauda equina syndrome. This will cause a delay in the diagnosis and treatment of the condition, which can leave the patient with permanent neurological symptoms. If this has happened to you, get in touch with us today to discuss claiming 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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