Cauda equina syndrome

Cauda equina syndrome
Cauda equina and filum terminale seen from behind.
ICD-10	G83.4
ICD-9	344.6
DiseasesDB	31115
MeSH	C10.668.829.800.750.700

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Joanna Ekabua, M.D. [2]

WikiDoc Resources for Cauda equina syndrome
Articles
Most recent articles on Cauda equina syndrome Most cited articles on Cauda equina syndrome Review articles on Cauda equina syndrome Articles on Cauda equina syndrome in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Cauda equina syndrome Images of Cauda equina syndrome Photos of Cauda equina syndrome Podcasts & MP3s on Cauda equina syndrome Videos on Cauda equina syndrome
Evidence Based Medicine
Cochrane Collaboration on Cauda equina syndrome Bandolier on Cauda equina syndrome TRIP on Cauda equina syndrome
Clinical Trials
Ongoing Trials on Cauda equina syndrome at Clinical Trials.gov Trial results on Cauda equina syndrome Clinical Trials on Cauda equina syndrome at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Cauda equina syndrome NICE Guidance on Cauda equina syndrome NHS PRODIGY Guidance FDA on Cauda equina syndrome CDC on Cauda equina syndrome
Books
Books on Cauda equina syndrome
News
Cauda equina syndrome in the news Be alerted to news on Cauda equina syndrome News trends on Cauda equina syndrome
Commentary
Blogs on Cauda equina syndrome
Definitions
Definitions of Cauda equina syndrome
Patient Resources / Community
Patient resources on Cauda equina syndrome Discussion groups on Cauda equina syndrome Patient Handouts on Cauda equina syndrome Directions to Hospitals Treating Cauda equina syndrome Risk calculators and risk factors for Cauda equina syndrome
Healthcare Provider Resources
Symptoms of Cauda equina syndrome Causes & Risk Factors for Cauda equina syndrome Diagnostic studies for Cauda equina syndrome Treatment of Cauda equina syndrome
Continuing Medical Education (CME)
CME Programs on Cauda equina syndrome
International
Cauda equina syndrome en Espanol Cauda equina syndrome en Francais
Business
Cauda equina syndrome in the Marketplace Patents on Cauda equina syndrome
Experimental / Informatics
List of terms related to Cauda equina syndrome

Overview

Cauda equina syndrome is a serious neurologic condition in which there is acute loss of function of the neurologic elements (nerve roots) of the spinal canal below the termination (conus) of the spinal cord.

Causes

The conus the canal contains a mass of nerves (the cauda equina) which travels caudally (toward the feet. Any lesion which compresses or disturbs the function of the cauda equina may disable the nerves, although the most common cause is a central disc prolapse. Other causes include protrusion of the vertebra into the canal if weakened by infection or tumor and an epidural abscess or hematoma.

Drug Side Effect

• Sulfasalazine

Signs

Signs include weakness of the muscles innervated by the compressed roots (often paraplegia), sphincter weaknesses causing urinary retention and post-void residual incontinence as assessed by catheterizing after the patient has voided. Also, there may be decreased rectal tone; sexual dysfunction; saddle anesthesia; bilateral leg pain and weakness; and bilateral absence of ankle reflexes. Pain may however, be wholly absent; the patient may complain only of lack of bladder control and of saddle-anaesthesia, and may walk into the consulting-room.

Diagnosis

Diagnosis is usually confirmed by an MRI scan or CT scan, depending on availability. If cauda equina syndrome exists, early surgery is an option depending on the etiology discovered and the patient's candidacy for major spine surgery.

Treatment

The management of true cauda equina syndrome is usually urgent surgical decompression.

Cauda equina syndrome is regarded as a medical emergency. Surgical decompression may be undertaken within 48 hours of symptoms developing if a compressive lesion, e.g. ruptured disc, is demonstrated. This treatment may significantly improve the chance that long-term neurological damage will be avoided. There are, however, no evidence-based medical standards that address the question of ultra-early versus delayed (48 hours) surgical decompression in cauda equina syndrome due to ruptured lumbar disc.

Prognosis

The prognosis for complete recovery is dependent upon many factors. The most important of these factors is the severity and duration of compression upon the damaged nerve(s). As a general rule the longer the interval of time before intervention to remove the compression causing nerve damage the greater the damage caused to the nerve(s).

Damage can be so severe and/or prolonged that nerve regrowth is impossible. In such cases the nerve damage will be permanent. In cases where the nerve(s) has been damaged but is still capable of regrowth, recovery time is widely variable. Quick surgical intervention can lead to complete recovery almost immediately afterward. Delayed or severe nerve damage can mean up to several years recovery time because nerve growth is exceptionally slow.

References

Template:Neuroscience-stub Template:Cerebral palsy and other paralytic syndromes [{Category:Needs patient information]] de:Cauda-equina-Syndrom