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https://pubmed.ncbi.nlm.nih.gov/33177221/
Cauda equina syndrome is a surgical emergency caused by compression of the cauda equina nerve roots. It can cause long term bladder, bowel & sexual dysfunction. Emergency medics & surgeons look carefully for it.1/12
Cauda equina syndrome is a surgical emergency caused by compression of the cauda equina nerve roots. It can cause long term bladder, bowel & sexual dysfunction. Emergency medics & surgeons look carefully for it.1/12
But most of the scans done looking for cauda equina syndrome are normal or non-explanatory- 81% mean over 18 studies in https://pubmed.ncbi.nlm.nih.gov/32059184/ . So what’s wrong with all the other people?
24% had cauda equina syndrome. What about the other 76%? Did they all have underlying neurological conditions causing their symptoms? No, 14 had neurological conditions diagnosed during admission. On 24month follow up 4 extra people got a neurological diagnosis. Total: 11%
76 patients had root compression/displacement and 61 had negative scans. For many symptoms, signs, medical and social history there was a dose-response effect with higher relative risk in mixed, and higher values again in ‘scan-negative’ patients.
Patients without CES compression were more likely to be female, have symptoms of a panic attack, dissociation & their worst ever back pain at symptom onset. Positive signs of a functional neurological disorder were significantly higher RR 1.5-2.6
Patients across all groups were in severe pain and used similar amounts of medications.
How would this work? How might pain (nerve root or muscular spasm), medications and prior bladder problems cause cauda equina syndrome symptoms? We’ll focus on the bladder
