Cauda Equina Syndrome vs. Transient Neurologic Symptoms

Question 1

Definition of Cauda Equina syndrome

Answer 1

permenant neurologic deficit, resulting in dysfunction of the bowel, bladder or both; perineal sensory loss; and variable lower extremity paresis

Question 2

What is the onset of CES?

Answer 2

immediate after causative injury

Question 3

What is CES related too?

Answer 3

pooling of large amounts of concentrated LA at lumbosacral roots
excessive exposure and toxic effects

Question 4

What is the treatment to CES?

Answer 4

supportive

Question 5

When does CES occur?

Answer 5

continuous spinal anesthesia

Question 6

What is TNS?

Answer 6

describes temporary symptoms that appear 1-24 hours after the complete resolution of spinal anesthetic, and disappear within a few days/week

Question 7

what are symptoms of TNS?

Answer 7

back pain, weakness/numbness radiating one/both buttocks or leg(s) (painful condition of buttocks and thighs)

Question 8

When is TNS more likely to occur?

Answer 8

occurred following hyperbaric spinal lidocaine administration
seen with use of 5% lidocaine for spinal anesthesia

Question 9

Lidocaine 5% and TNS occurs as much as what %

Answer 9

40%

Question 10

Incidence of bupivacaine and TNS?

Answer 10

3%

Question 11

Incidence of TNS and tetracaine?

Answer 11

1.6%

Question 12

In animal studies, what did the high concentrations of lidocaine show?

Answer 12

lidocaine and tetracaine were toxic to unsheathed nerves

Question 13

What are contributing factors to TNS?

Answer 13

lithotomy or hip/knee bent

thought is the stretching of lumbosacral nerve roots = TNS

Question 14

What can cause TNS?

Answer 14

all local anesthestics

Question 15

What LA has the highest incidence of TNS?

Answer 15

lidocaine

Question 16

What is the main difference between CES and TNS?

Answer 16

TNS is a PAIN disorder exclusively to pain in buttocks thigh and legs no dysfunction seen