A patient who presents with the symptoms of cauda equina syndrome must undergo a detailed neurological examination in order to confirm/exclude a diagnosis.
Cauda equina syndrome symptoms
Cauda equina syndrome is when the nerves at the bottom of the spinal cord are compressed. This will result in a loss of function, causing symptoms such as:-
- Loss of sensation in the perineum, buttocks, legs and urethra
- Bladder dysfunction, with increased function, difficulty emptying the bladder and the need to strain
- Chronic back pain
- Sexual dysfunction, with loss of sensation and inability to achieve an erection
Any patient presenting to their GP or A&E department with these symptoms should be investigated for cauda equina syndrome. This must first involve a detailed neurological examination.
Cauda equina syndrome neurological examination
The examination to confirm or exclude a possible diagnosis of cauda equina syndrome should include the following:-
- A detailed sensory examination of the perineal, perianal and saddle region. This will verify whether there is an absence of sensation
- A digital rectal examination, to test whether these is reduced anal tone
- Reflex tests on the lower limbs, to see if there is foot drop and poor reflexes
- If appropriate, a catheter tug
The medical practitioner conducting the examination must records the negative and positive aspects of the assessment. Blood and urine tests should also ordered to check whether a patient’s symptoms are being caused by another condition, such as a urinary tract infection.
Diagnosing cauda equina syndrome
If the test results do not indicate another condition and the examination results are suggestive of cauda equina syndrome, a patient should be sent for an MRI scan. This will reveal whether or not the cauda equina nerves are being compressed.
If medical practitioners fail to carry out a detailed examination, or fail to note the positive/negative aspects of the examination, the standard of care must be called in to question. If this causes a patient to suffer unnecessary complications, there will be grounds for a medical negligence compensation claim.
Claiming compensation for cauda equina syndrome
If your diagnosis of cauda equina syndrome was delayed because medical practitioners failed to recognise the signs and symptoms of nerve compression, you could be entitled to claim compensation for the damages incurred. To find out more, please get in touch with us today and speak to one of our specialist cauda equina solicitors.