Cauda equina syndrome: Difference between revisions
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For every cause, pressure is put on or direct damage is done to the nerves in the cauda equina. | For every cause, pressure is put on or direct damage is done to the nerves in the cauda equina. | ||
*[[Tumour]] - this puts pressure on the cauda equina and is often a [[metastasis]] | *[[Tumour]] - this puts pressure on the cauda equina and is often a [[metastasis]] | ||
*[[Trauma]] - direct damage to the nerves | *[[Trauma]] - direct damage to the nerves. Usually due to a [[prolapsed vertebral disc]] | ||
*[[Spinal stenosis]] - due to a number of causes, the spinal canal becomes smaller, putting pressure on the nerves within | *[[Spinal stenosis]] - due to a number of causes, the spinal canal becomes smaller, putting pressure on the nerves within | ||
*[[Inflammation]] - things like [[Paget's disease of bone]] and [[ankylosing spondylitis]] get inflamed, putting pressure on the nerves. | *[[Inflammation]] - things like [[Paget's disease of bone]] and [[ankylosing spondylitis]] get inflamed, putting pressure on the nerves. | ||
===Clinical Features=== | ===Clinical Features=== | ||
*[[Urinary incontinence|Urinary]] and faecal incontinence - reduction in sphincter power | *[[Urinary incontinence|Urinary]] and faecal incontinence - reduction in sphincter power | ||
Revision as of 12:21, 22 December 2009
Definition
Acute loss of neurological function in the nerve roots below the end of the spinal cord (usually below abouot L1, L2).
Epidemiology
Essentially, many of the things that cause cauda equina syndrome are incredibly serious. The damage, if untreated, can become permanent.
Pathophysiology
For every cause, pressure is put on or direct damage is done to the nerves in the cauda equina.
- Tumour - this puts pressure on the cauda equina and is often a metastasis
- Trauma - direct damage to the nerves. Usually due to a prolapsed vertebral disc
- Spinal stenosis - due to a number of causes, the spinal canal becomes smaller, putting pressure on the nerves within
- Inflammation - things like Paget's disease of bone and ankylosing spondylitis get inflamed, putting pressure on the nerves.
Clinical Features
- Urinary and faecal incontinence - reduction in sphincter power
- Saddle anaesthesia (losing feeling in the bits of you that would touch a saddle - genitals, perineum, anus. That sort of area.)
- Lower motor neurone weakness - reduced power, tone and reflexes. Can lead to paralysis.
- Back pain and leg pain - radicular pain (along a dermatome) down legs
Investigations
- MRI and CT scans are done to accurately pinpoint nature and site of lesion. Occasionaly, urodynamics is done.