Cauda Equina Flashcards
1
Q
What is cauda equina syndrome?
A
Surgical emergency caused by the compression of the cauda equina
2
Q
What is the cauda equina?
A
Bundle of nerves inferior to spinal cord
Spinal cords ends at L1
Nerve roots L1-S5 pass down spinal canal as cauda equina
Form of lower motor neurones
- motor/sensory impulses to lower limbs
- motor innervation to anal sphincters
- parasympathetic innervation to bladder
3
Q
Causes of cauda equina
A
Disc herniation Trauma Neoplasm Infection Iatrogenic
4
Q
Clinical features of cauda equina
A
Lower motor neurone signs Reduced lower limb sensation Bladder/bowel dysfunction Lower limb motor weakness Saddle anaesthesia
5
Q
What are lower motor neurone signs?
A
Weakness Wasting Hypotonia Areflexia Fasiculations
6
Q
Investigations for suspected cauda equina
A
PR exam
Post-void bladder scan
Urgent whole spine MRI
7
Q
Classification of cauda equina
A
CESR (cauda equina syndrome with retention)
- back pain
- unilateral/bilateral sciatica
- lower limb motor weakness
- saddle anaesthesia
- loss of anal tone
- loss of urinary control
CESI (incomplete cauda equina syndrome)
- back pain
- unilateral/bilateral sciatica
- lower limb motor weakness
- saddle anaesthesia
- loss of anal tone
- altered urinary sensation
CESS (suspected cauda equina syndrome)
- severe back + leg pain
- variable neurological signs
- suggestion of sphincter disturbance
8
Q
Management of cauda equina syndrome
A
High dose steroids - reduce local swelling
Surgical decompression
