June 25, 2018

Episode 151.0 – Cauda Equina Syndrome

5 minutes

This week we discuss the difficult to diagnose and high morbidity cauda equina syndrome.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_151_0_Final_Cut.m4a

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Tags: Back Pain, Cauda Equina

Show Notes

Take Home Points

Cauda equina syndrome is a rare emergency with devastating consequences

Early recognition is paramount as the presence of bladder dysfunction portends bad functional outcomes

The presence of bilateral lower extremity weakness or sensory changes should alert clinicians to the diagnosis. Saddle anesthesia (or change in sensation) and any bladder/bowel changes in function should also raise suspicion for the disorder

MRI is the diagnostic modality of choice though CT myelogram can be performed if necessary

Prompt surgical consultation is mandatory for all patients with cauda equina syndrome regardless of symptoms at presentation

Read More

EM Cases: Best Case Ever 11: Cauda Equina Syndrome

OrthoBullets: Cauda Equina Syndrome

Radiopaedia: Cauda Equina Syndrome

Perron AD, Huff JS: Spinal Cord Disorders, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 106: p 1419-30.

References

Lavy C et al. Cauda Equina Syndrome. BMJ 2009; 338: PMID: 19336488

Todd NV. Cauda equina syndrome: the timing of surgery probably does influence outcome. Br J Neurosurg 2005;19:301-6 PMID: 16455534

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