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Cauda Equina Syndrome Misdiagnosis

Cauda Equina Syndrome Misdiagnosis


Cauda equina syndrome (CES) arises through damage or compression to the cauda equina (Latin for horse's tail). The Cauda Equina is a bundle of nerves at the lower end of the spinal cord in the lumbosacral spine. The bundle of nerves sends and receive messages to and from your legs, feet, and pelvic organs.

Causes of cauda equina syndrome include:

  • Infections or inflammatory conditions of the lower spine;
  • Severe herniated/ruptured disc in the lumber area;
  • Lumbar spinal stenosis;
  • Tumor in the lower spinal region;
  • Congenital spine disorders;
  • Traumatic injury, i.e., car crash, fall, or penetrating injuries (gunshot, stabbing); and
  • Those who lift heavy objects or have arthritis in the spine are also vulnerable.

When CES is correctly diagnosed, it can be treated effectively. The onset of CES symptoms necessitates urgent medical attention for proper diagnosis and immediate treatment to prevent permanent damage leading to incontinence and possibly permanent paralysis of the legs. (mayo However, the failure to diagnose CES is a serious medical mistake which can cause physical, emotional, and financial suffering for the rest of your life. Your loved ones are often affected as well because CES can cause severe and permanent disabilities.

Why is CES Misdiagnosed or Undiagnosed?

One of the reasons CES can be misdiagnosed or undiagnosed is because it is rare.  But, CES should always be considered as a possible diagnosis anytime a patient presents to the health care provider with neurological symptoms consistent with possible spinal cord compression. CES signs and symptoms can also mimic other conditions. These varying symptoms mean it can be difficult to diagnose the condition. It is also important to note that the symptoms of CES can vary and can come and go over time. Another cause contributing to a misdiagnosed or undiagnosed case of CES is merely because the health care provider made a medical mistake by failing to timely and/or properly diagnoses CES.

Symptoms include, but may not be limited to:

  • Lower back pain;
  • Sciatica;
  • Loss of movement;
  • Loss or altered sensation, including the ability to feel heat, cold, and touch;
  • Loss of bowel or bladder control;
  • Sensory abnormalities in the bladder or rectum;
  • Exaggerated reflex activities or spasms;
  • Changes in sexual function, sexual sensitivity, and fertility;
  • Pain or an intense stinging sensation caused by damage to the nerve fibers in your

spinal cord;

  • Difficulty breathing, coughing, or clearing secretions from your lungs;
  • Motor weakness, sensory loss, pins and needles, numbness or pain in one, or more

commonly, both legs/feet (which affects mobility);

  • Loss of reflexes in the extremities toes/ankles/lower leg;
  • A dropped foot or feet where the foot drags along or similar sensation;
  • Saddle anesthesia (diminished/altered sensation or unable to feel anything in the

body areas that sit on a saddle); and

  • Recent onset of sexual dysfunction.

Emergency signs and symptoms of a spinal cord injury after an accident may include:

  • Extreme back pain or pressure in your neck, head, or back;
  • Weakness, incoordination, or paralysis in any part of your body;
  • Numbness, tingling, or loss of sensation in your hands, fingers, feet, or toes;
  • Loss of bladder or bowel control;
  • Difficulty with balance and walking;
  • Impaired breathing after injury; and
  • An oddly positioned or twisted neck or back.


Diagnosing CES

Diagnosis of CES is usually done by a physical examination, a review of your medical history, and an MRI scan (uses magnetic fields and computers to produce three-dimensional images of your spine); and/or a CT scan (computed tomography used to create detailed images of internal organs, bones, soft tissue and blood vessels); and/or a myelogram, which is an x-ray of the spinal canal after injection of contrast material which can pinpoint pressure on the spinal cord or nerves).

If a spinal cord compression is diagnosed, surgery is almost always indicated on an urgent basis to prevent or limit spinal cord damage, including bowel and bladder function.

Your health care provider owes you a duty of care. If you present with symptoms of CES, and your doctor does not order the necessary tests to diagnose, or rule out, CES, or if you are discharged from care without a referral for a specialist examination to check for CES, then you may have a claim of medical negligence.

When a health care professional makes a mistake, the consequences can be devastating. If this has happened to you or your loved one, call our NC medical malpractice attorneys today at 704-714-1450. We have the expertise and experience in matters involving medical malpractice and will thoroughly investigate your claim and zealously fight for your right to just compensation.



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