Doctor's Notes on Cauda Equina Syndrome
Cauda equina syndrome (CES) is compression and/or inflammation of nerves in the lower portion of the spinal canal. If left untreated, it can lead to permanent loss of bowel and bladder control and cause paralysis of the legs. Consequently, it is considered a medical emergency. Signs and symptoms of cauda equina syndrome may include
- low back pain,
- pain in one or both legs that start at the buttocks and travels down the leg,
- numbness in the groin area,
- bowel and bladder disturbances (bowel incontinence, constipation, loss of anal muscle and sensation, urinary retention, urinary hesitancy and/or incontinence, and decreased urethral sensation),
- lower extremity muscle weakness,
- lower extremity loss of sensation, and
- reduced or absent lower extremity reflexes.
The cause of cauda equina syndrome is significant narrowing of the spinal canal that compresses nerve roots below the level of the spinal cord. The underlying causes for this significant narrowing are many. They include trauma, herniated discs, spinal stenosis (due to developmental or degenerative problems), tumors, inflammation, infections of the spinal canal, and accidental medical causes during surgeries.
What Is the Treatment for Cauda Equina Syndrome (CES)?
CES is considered by most doctors as an emergency that should be treated within 48 hours of symptoms and for the best outcomes. The best treatment is surgery to reduce and/or stop whatever is causing pressure (see above causes) on the nerves. In addition, rest and drugs are given to reduce swelling and pain. Your surgeon will determine the medications depending on the underlying problems that triggered CES.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.