Cauda equina syndrome

Cauda equina syndrome is a serious neurologiccondition in which there is compression of the contents of the spinal canal below the termination (conus) of the spinal cord. After the conus the canal contains a mass of nerves (the cauda equina) which travels caudally (toward the feet).

Any lesion which compresses the cauda equina may cause dysfunction of the nerves although the commonest is a central disc prolapse. Other causes include protrusion of the vertebra into the canal if weakened by infecion or tumour and an epidural abscess or haemaoma.

Cauda equina syndrome is regarded as a medical emergency, although there is no good evidence that earliest possible operation leads to a better result than after a delay.

Signs

Signsinclude weakness of the muscles innvervated by the compressed roots (often paraplegia), sphincter weaknesses causing urinaryretention and post-void residual incontinence as assessed by catheterizing after the patient has voided. Also, there may be decreased rectaltone; sexual dysfunction; saddle anesthesia; bilateral legpainand weakness; and bilateral absence of ankle reflexes.

Diagnosis is usually confirmed by an MRI scan.

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

The prognosis for complete recovery is often poor, in spite of emergency operation.

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It uses material from the http://en.wikipedia.org/wiki/Cauda+equina+syndrome Wikipedia article Cauda equina syndrome.