Cauda equina syndrome
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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
- 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
- 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.