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Chinese Medical Journal May 2009To review the literature on the clinical progress in cauda equina syndrome (CES), including the epidemic history, pathogenesis, diagnosis, treatment policy and... (Review)
Review
OBJECTIVE
To review the literature on the clinical progress in cauda equina syndrome (CES), including the epidemic history, pathogenesis, diagnosis, treatment policy and prognosis. Data sources All reports on CES in the literature were searched in PubMed, Ovid, Springer, Elsevier, and the Chinese Biomedical Literature Disk using the key terms "cauda equina syndrome", "diagnosis", "treatment", "prognosis" and "evidence-based medicine". Study selection Original milestone articles and critical reviews written by major pioneer investigators about the cauda equina syndrome were selected.
RESULTS
CES is rare, both atraumatically and traumatically. Males and females are equally affected. The incidence of CES is variable, depending on the etiology of the syndrome. The most common cause of CES is herniation of a lumbar intervertebral disc. CES symptoms may have sudden onset and evolve rapidly or sometimes chronic ally. Each type of CES has different typical signs and symptoms. Low back pain may be the most significant symptoms, accompanied by sciatica, lower extremities weakness, saddle or perianal hypoesthesia, sexual impotence, and sphincter dysfunction. MRI is usually the preferred investigation approach. Patients who have had CES are difficult to return to a normal status.
CONCLUSIONS
The diagnosis of CES is primarily based on a careful history inquiry and clinical examination, assisted by elective radiologic investigations. Early diagnosis and early surgical decompression are crucial for a favorable outcome in most CES cases.
Topics: Evidence-Based Medicine; Female; Humans; Magnetic Resonance Imaging; Male; Polyradiculopathy
PubMed: 19493474
DOI: No ID Found -
The Cornell Veterinarian Oct 1989Lumbar polyradiculopathy, characterized by ballooning myelin sheaths and axonal distortion, was documented in multiple, aged, domestic, laboratory, and exotic mammalian...
Lumbar polyradiculopathy, characterized by ballooning myelin sheaths and axonal distortion, was documented in multiple, aged, domestic, laboratory, and exotic mammalian species. Animals studied that exhibited this nerve rootlet change included the goat, sheep, pig, white-tailed deer, gerbil, vole, ferret, beaver, hedgehog, chinchilla, North Chinese leopard, lion, cheetah, mountain lion, llama, East African eland, Uganda giraffe, polar bear, and drill. Ultrastructurally, lumbar nerve rootlets from the North Chinese leopard revealed prominent and often multiple lamellar separations in the area of myelin bubbling. Clefts in myelin sheaths contained macrophages with engulfed fragments of myelin. Axons were sometimes variously attenuated, and the axoplasm contained densely packed neurofilaments. In all species, the lesion was subclinical and considered an incidental age-related finding.
Topics: Aging; Animals; Artiodactyla; Carnivora; Female; Hedgehogs; Lumbosacral Region; Male; Mammals; Microscopy, Electron; Papio; Polyradiculopathy; Rodentia
PubMed: 2766747
DOI: No ID Found -
Neurosurgical Focus Jun 2004
Review
Topics: Ambulatory Care; Humans; Length of Stay; Polyradiculopathy; Referral and Consultation; United States
PubMed: 15202878
DOI: 10.3171/foc.2004.16.6.7 -
Definitions of traumatic conus medullaris and cauda equina syndrome: a systematic literature review.Spinal Cord Oct 2017A systematic review. (Review)
Review
STUDY DESIGN
A systematic review.
OBJECTIVES
Conus medullaris syndrome (CMS) and cauda equina syndrome (CES) are well-known neurological entities. It is assumed that these syndromes are different regarding neurological and functional prognosis. However, literature concerning spinal trauma is ambiguous about the exact definition of the syndromes.
METHODS
A MEDLINE, EMBASE and Cochrane literature search was performed. We included original articles in which clinical descriptions of CMS and/or CES were mentioned in patients following trauma to the thoracolumbar spine.
RESULTS
Out of the 1046 articles, we identified 14 original articles concerning patients with a traumatic CMS and/or CES. Based on this review and anatomical data from cadaveric and radiological studies, CMS and CES could be more precisely defined.
CONCLUSION
CMS may result from injury of vertebrae Th12-L2, and it involves damage to neural structures from spinal cord segment Th12 to nerve root S5. CES may result from an injury of vertebrae L3-L5, and it involves damage to nerve roots L3-S5. This differentiation between CMS and CES is necessary to examine the hypothesis that CES patients tend to have a better functional outcome.
Topics: Humans; Nerve Compression Syndromes; Polyradiculopathy; Spinal Cord Compression; Terminology as Topic
PubMed: 28534496
DOI: 10.1038/sc.2017.54 -
Annals of Neurology Sep 1998Clinical and electrophysiological features in 43 children with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) were retrospectively studied. More than...
Clinical and electrophysiological features in 43 children with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) were retrospectively studied. More than one-third of these children were less than 3 years old. Some distinctive clinical features specific to adults or to children were identified. Initial symptoms such as ataxia and severe limb or back pain were more frequent in children. By using the criteria suggested here, according to our neurophysiological findings, the diagnosis of AIDP could be proposed as early of the first days of illness in 90% of the children and is confirmed during the second week. The neurophysiological evolution was very similar in children and adults except that recovery occurred sooner in children. Prognosis was better in childhood (complete recovery in all but 2 patients with minor disabilities).
Topics: Acute Disease; Adolescent; Child; Child, Preschool; Demyelinating Diseases; Electrodiagnosis; Female; Humans; Infant; Male; Polyradiculopathy; Retrospective Studies; Spinal Nerve Roots
PubMed: 9749601
DOI: 10.1002/ana.410440310 -
Lancet (London, England) Feb 1970
Topics: Humans; Mycoplasma; Polyradiculopathy
PubMed: 4189612
DOI: 10.1016/s0140-6736(70)90735-x -
Lancet (London, England) Dec 1972
Topics: Antibodies, Viral; Female; Herpesvirus 4, Human; Humans; Male; Polyradiculopathy; Sarcoidosis
PubMed: 4117616
DOI: 10.1016/s0140-6736(72)92618-9 -
British Journal of Neurosurgery 2015Fifty-six human and animal studies of cauda equina syndrome (CES) were reviewed. The evidence from human studies was poor (level IV). Evidence from animal studies and... (Review)
Review
Fifty-six human and animal studies of cauda equina syndrome (CES) were reviewed. The evidence from human studies was poor (level IV). Evidence from animal studies and limited evidence from human studies suggest that structural and functional neurological losses are a progressive, continuous process. The longer the cauda equina nerve roots are compressed the greater the harm and the poorer the extent of recovery. This should prompt diagnosis and surgery for all CES patients as soon as practicably possible.
Topics: Animals; Evidence-Based Medicine; Humans; Neurodegenerative Diseases; Polyradiculopathy; Recovery of Function
PubMed: 26401618
DOI: 10.3109/02688697.2015.1054364 -
European Journal of Clinical... Aug 1999
Topics: AIDS-Related Opportunistic Infections; Adult; Cytomegalovirus Infections; Diagnosis, Differential; Humans; Male; Paralysis; Polyradiculopathy; Radial Neuropathy
PubMed: 10517204
DOI: 10.1007/s100960050359 -
Praxis Nov 2011Lumbar disc herniation has a high prevalence and strong social-medical impact. Patients suffer from lower back pain that radiates from the spine. Loss of sensation or... (Review)
Review
Lumbar disc herniation has a high prevalence and strong social-medical impact. Patients suffer from lower back pain that radiates from the spine. Loss of sensation or paresis adds to the clinical picture. The diagnosis should be confirmed by imaging in patients considered for surgery. High remission rates initially warrant conservative treatment (adequate analgesia and physiotherapy) in many patients. If this treatment does not lead to significant alleviation within 5-8 weeks, surgery should be performed to reduce the risk of chronic nerve affection. Posterior interlaminar fenestration is the intervention primarily conducted for this diagnosis. A relapse in the same region occurs in up to 10% of patients after months through years, which sometimes necessitates a reoperation if symptoms are pertinent.
Topics: Aged; Algorithms; Diagnosis, Differential; Female; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Nerve Compression Syndromes; Neurologic Examination; Polyradiculopathy; Spinal Cord; Spinal Nerves; Tomography, X-Ray Computed
PubMed: 22124958
DOI: 10.1024/1661-8157/a000733