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Journal of Neurology Dec 2001
Topics: Central Nervous System Diseases; Dura Mater; Humans; Polyradiculopathy; Siderosis; Spinal Cord
PubMed: 12013591
DOI: 10.1007/pl00021252 -
Continuum (Minneapolis, Minn.) Feb 2015Cauda equina syndrome is an important neurologic disorder characterized by lower back pain, sciatica, perineal numbness, and sphincter dysfunction. This article reviews... (Review)
Review
PURPOSE OF REVIEW
Cauda equina syndrome is an important neurologic disorder characterized by lower back pain, sciatica, perineal numbness, and sphincter dysfunction. This article reviews the anatomy, clinical presentation, evaluation, and treatment of cauda equina dysfunction, focusing on diskogenic cauda equina syndrome.
RECENT FINDINGS
Assessment of suspected cauda equina syndrome is hampered by modest diagnostic accuracy of any one clinical feature. Although urgent operation for diskogenic cauda equina syndrome is standard practice, most data about timing of intervention comes from small case series; however, randomized trials are very unlikely given the ethical implications of delaying surgical intervention.
SUMMARY
In the absence of high-quality data indicating otherwise, urgent evaluation and intervention are required for diskogenic cauda equina syndrome. Other etiologies of cauda equina dysfunction including neoplastic, infectious, and iatrogenic causes must also be considered, especially in the setting of normal neuroimaging studies.
Topics: Humans; Intervertebral Disc; Polyradiculopathy
PubMed: 25651223
DOI: 10.1212/01.CON.0000461090.09736.45 -
JAMA Neurology Aug 2015
Topics: Aged; Dendritic Cells; Hematologic Neoplasms; Humans; Magnetic Resonance Imaging; Male; Polyradiculopathy; Skin Neoplasms
PubMed: 26099022
DOI: 10.1001/jamaneurol.2015.0830 -
Developmental Medicine and Child... Aug 1968
Topics: Adolescent; Child; Electroencephalography; Female; Humans; Male; Neural Conduction; Peripheral Nerves; Peripheral Nervous System Diseases; Physical Therapy Modalities; Polyradiculopathy
PubMed: 4300715
DOI: 10.1111/j.1469-8749.1968.tb02923.x -
BMJ (Clinical Research Ed.) Mar 2009
Review
Topics: Humans; Magnetic Resonance Imaging; Physical Examination; Polyradiculopathy; Practice Guidelines as Topic; Referral and Consultation; Tomography, X-Ray Computed
PubMed: 19336488
DOI: 10.1136/bmj.b936 -
Neurology Jul 1986We studied three patients with acquired immune deficiency syndrome (AIDS) and progressive polyradiculopathy. Postmortem examination of one patient disclosed extensive...
We studied three patients with acquired immune deficiency syndrome (AIDS) and progressive polyradiculopathy. Postmortem examination of one patient disclosed extensive necrosis, inflammatory infiltrates, and focal vasculitis of spinal roots. Typical cytomegaloviral (CMV), intranuclear, and intracytoplasmic inclusions were noted within enlarged endoneurial and endothelial cells. Progressive polyradiculopathy is an unusual complication of AIDS; CMV may be the causative agent in certain cases.
Topics: Acquired Immunodeficiency Syndrome; Adult; Cauda Equina; Cytomegalovirus Infections; Humans; Lumbar Vertebrae; Male; Polyradiculopathy; Sacrum; Spinal Nerve Roots; Tomography, X-Ray Computed
PubMed: 3012412
DOI: 10.1212/wnl.36.7.912 -
The Veterinary Clinics of North... Jan 2000This article reviews the management of degenerative lumbosacral stenosis. Degenerative lumbosacral stenosis occurs when soft tissue and bony changes, possibly in... (Review)
Review
This article reviews the management of degenerative lumbosacral stenosis. Degenerative lumbosacral stenosis occurs when soft tissue and bony changes, possibly in conjunction with abnormal motion of the lumbosacral joint, impinge on the nerve roots or vasculature of the cauda equina. It occurs most frequently in middle-aged dogs of medium to large breed, especially the German Shepherd dog. Common signs are lumbosacral pain, lameness, pelvic limb weakness and ataxia, and urinary incontinence. Diagnosis is based on clinical features and imaging studies. Decompressive surgery is effective in most patients.
Topics: Animals; Cat Diseases; Cats; Diagnosis, Differential; Dog Diseases; Dogs; Magnetic Resonance Imaging; Myelography; Polyradiculopathy; Spinal Stenosis; Tomography, X-Ray Computed
PubMed: 10680211
DOI: 10.1016/s0195-5616(00)50005-9 -
The Journal of Pediatrics Mar 2015
Topics: Abnormalities, Multiple; Cauda Equina; Diagnosis, Differential; Female; Humans; Infant, Newborn; Perineum; Polyradiculopathy
PubMed: 25529605
DOI: 10.1016/j.jpeds.2014.11.035 -
Progress in Neurobiology Aug 2001Single or double-level compression of the lumbosacral nerve roots located in the dural sac results in a polyradicular symptomatology clinically diagnosed as cauda equina... (Review)
Review
Single or double-level compression of the lumbosacral nerve roots located in the dural sac results in a polyradicular symptomatology clinically diagnosed as cauda equina syndrome. The cauda equina nerve roots provide the sensory and motor innervation of most of the lower extremities, the pelvic floor and the sphincters. Therefore, in a fully developed cauda equina syndrome, multiple signs of sensory disorders may appear. These disorders include low-back pain, saddle anesthesia, bilateral sciatica, then motor weakness of the lower extremities or chronic paraplegia and, bladder dysfunction. Multiple etiologies can cause the cauda equina syndrome. Among them, non-neoplastic compressive etiologies such as herniated lumbosacral discs and spinal stenosis and spinal neoplasms play a significant role in the development of the cauda equina syndrome. Non-compressive etiologies of the cauda equina syndrome include ischemic insults, inflammatory conditions, spinal arachnoiditis and other infectious etiologies. The use of canine, porcine and rat models mimicking the cauda equina syndrome enabled discovery of the effects of the compression on nerve root neural and vascular anatomy, the impairment of impulse propagation and the changes of the neurotransmitters in the spinal cord after compression of cauda equina. The involvement of intrinsic spinal cord neurons in the compression-induced cauda equina syndrome includes anterograde, retrograde and transneuronal degeneration in the lumbosacral segments. Prominent changes of NADPH diaphorase exhibiting, Fos-like immunoreactive and heat shock protein HSP72 were detected in the lumbosacral segments in a short-and long-lasting compression of the cauda equina in the dog. Developments in the diagnosis and treatment of patients with back pain, sciatica and with a herniated lumbar disc are mentioned, including many treatment options available.
Topics: Animals; Cauda Equina; Disease Models, Animal; Humans; Nerve Compression Syndromes; Polyradiculopathy
PubMed: 11311464
DOI: 10.1016/s0301-0082(00)00065-4 -
The Journal of the American Academy of... Aug 2008Cauda equina syndrome is a relatively uncommon condition typically associated with a large, space-occupying lesion within the canal of the lumbosacral spine. The... (Review)
Review
Cauda equina syndrome is a relatively uncommon condition typically associated with a large, space-occupying lesion within the canal of the lumbosacral spine. The syndrome is characterized by varying patterns of low back pain, sciatica, lower extremity sensorimotor loss, and bowel and bladder dysfunction. The pathophysiology remains unclear but may be related to damage to the nerve roots composing the cauda equina from direct mechanical compression and venous congestion or ischemia. Early diagnosis is often challenging because the initial signs and symptoms frequently are subtle. Classically, the full-blown syndrome includes urinary retention, saddle anesthesia of the perineum, bilateral lower extremity pain, numbness, and weakness. Decreased rectal tone may be a relatively late finding. Early signs and symptoms of a developing postoperative cauda equina syndrome are often attributed to common postoperative findings. Therefore, a high index of suspicion is necessary in the postoperative spine patient with back and/or leg pain refractory to analgesia, especially in the setting of urinary retention. Regardless of the setting, when cauda equina syndrome is diagnosed, the treatment is urgent surgical decompression of the spinal canal.
Topics: Decompression, Surgical; Humans; Hypesthesia; Low Back Pain; Polyradiculopathy; Spinal Canal; Treatment Outcome; Urinary Retention
PubMed: 18664636
DOI: 10.5435/00124635-200808000-00006