Cauda Equina Syndrome – A Medical Emergency
As a medical emergency, doctors must not delay in diagnosing and treating a patient with Cauda Equina Syndrome. If there is a set back for any reason, perhaps because a wrong diagnosis is made, then the patient's prospect of recovery will be severely hindered.
Making A Prompt Diagnosis
Cauda Equina Syndrome is a medical emergency which occurs when the bundle of nerves located at the bottom of the spine (called the 'cauda equina') becomes compressed. It is a rare but extremely serious condition, and prognosis is entirely dependent upon a prompt diagnosis being made. Otherwise the chances of a patient making a full recovery will be reduced. Doctors must, therefore, do all they can to ensure a patient suffering from Cauda Equina is diagnosed swiftly. As with all medical conditions, this should begin with an assessment of symptoms, while possible causes should also be considered. These are explored in more detail below:-
Causes of Cauda Equina Syndrome include:-
- Severe trauma (such as a car crash);
- Tumours;
- Prolapsed disc;
- Spinal stenosis;
- Inflammatory conditions;
- Infectious conditions.
Symptoms of Cauda Equina Syndrome include:-
- Lower back pain;
- Pain in the buttocks which spreads to the legs;
- Saddle anaesthesia;
- Urinary problems (such as urgency, incontinence, hesitancy, retention);
- Decreased urethral sensation;
- Loss of anal tone/sensation.
What Is The Outlook?
If Cauda Equina Syndrome is suspected, doctors should not delay in confirming their beliefs. This can be done through a number of tests, including a physical examination to test sensation, muscle tone and reflexes in the lower extremities (such as the legs and the perineum), as well as an MRI scan. Once a diagnosis has been made, treatment should be quickly arranged, as the nerves need to be decompressed as soon as possible. To determine what type of treatment will be most effective, it will also be necessary to recognise what the underlying cause is. For example, if the cauda equina is being compressed due to an inflammatory condition, anti-inflammatory medication should be administered. More often than not, however, urgent surgery will be needed.
Prognosis will therefore depend upon how quickly the correct form of treatment is provided. It is generally considered that if the nerves are decompressed within 48 hours of symptoms developing, the chance of a patient making a full recovery will be greatly improved. However, if symptoms persist for a period greater than 48 hours, it is very possible a patient will be left with long-term complications. These may include urinary problems such as incontinence, impaired bladder function and reduced sensation in the lower extremities.
Cauda Equina Syndrome and Medical Negligence
If doctors fail to diagnose and treat Cauda Equina Syndrome in a timely fashion and a patient is left to suffer as a result, there may well be a case of medical negligence. A solicitor specialising in this area of law will be able to provide more information, but if it can be proven treatment fell below an acceptable standard, it will be possible for that person to make a claim.
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