Cauda Equina Syndrome* (CES)

Cauda Equina means “horses” tail in Latin.

It is the name for the collection of nerves in the vertebral column below what is known as the conus medullaris.

Crucially it lacks the protection of the spinal column.

Cauda equina syndrome (CES) occurs when the nerve roots of the cauda equina are compressed and disrupt motor and sensory function to the lower extremities and bladder. Patients with this syndrome are often admitted to the hospital as a medical emergency. CES can lead to incontinence of urine or bowel and even permanent paralysis.

Patients with back pain should be aware of the following “red flag” symptoms that may indicate CES:

  • Severe low back pain
  • Motor weakness
  • Sensory loss
  • Pain in one, or more commonly both legs
  • Saddle anaesthesia (unable to feel anything in the body areas that sit on a saddle)

The causes of Cauda Equina or at least the most common causes are:

  • A severe ruptured disk in the lumbar area ( the most common cause)
  • Narrowing of the spinal canal ( stenosis)
  • A spinal lesion or malignant tumour
  • A spinal infection, inflammation, haemorrhage, or fracture
  • A complication from a severe lumbar spine injury  such as a car crash, fall, gunshot , or stabbing
  • A birth defect such as an abnormal connection between blood vessels

If you have Cauda Equina Syndrome, you will need urgent treatment to relieve the pressure on the nerves – Surgery must be carried out expeditiously in an attempt to prevent permanent damage, such as paralysis of the legs or partial paralysis, loss of bladder and bowel control , sexual function or other problems. You may need medication to reduce swelling or an infection. If the cause is a tumour you may need radiotherapy or surgery.

Even with treatment you may not retrieve full function. It will depend on how much damage is done.

You can seek help from an occupational therapist, a social worker , a continence advisor or physiotherapist.

Cauda Equina may also be a hot bed for litigation. GP’s or young doctors often miss the signs ( the red flags above) and do not direct  immediate surgery. Believing the the problem is just a bad back or slipped disc they discharge them. This is where the problems can begin. The lawyers will engage experts to show that the cauda equina should have been diagnosed and if it had been the damage would not have occurred at all or at least not as much damage. Any case that that the person has may then be quantified.

If you have suffered from Cauda Equina and there was not an immediate diagnosis you should contact your lawyer. He / she can advise you from there.

Should you have any queries, please call Ralph McMahon, McMahon Goldrick Solicitors, 34, Grafton Buildings, Grafton Street, Dublin 2. 01 6770044

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