Episode 151.0 – Cauda Equina Syndrome

Episode 151.0 – Cauda Equina Syndrome

Author: Core EM June 25, 2018 Duration: 5:04

This week we discuss the difficult to diagnose and high morbidity cauda equina syndrome.

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Show Notes

Take Home Points

  • Cauda equina syndrome is a rare emergency with devastating consequences
  • Early recognition is paramount as the presence of bladder dysfunction portends bad functional outcomes
  • The presence of bilateral lower extremity weakness or sensory changes should alert clinicians to the diagnosis. Saddle anesthesia (or change in sensation) and any bladder/bowel changes in function should also raise suspicion for the disorder
  • MRI is the diagnostic modality of choice though CT myelogram can be performed if necessary
  • Prompt surgical consultation is mandatory for all patients with cauda equina syndrome regardless of symptoms at presentation

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EM Cases: Best Case Ever 11: Cauda Equina Syndrome

OrthoBullets: Cauda Equina Syndrome

Radiopaedia: Cauda Equina Syndrome

Perron AD, Huff JS: Spinal Cord Disorders, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 106: p 1419-30.

References

Lavy C et al. Cauda Equina Syndrome. BMJ 2009; 338: PMID: 19336488

Todd NV. Cauda equina syndrome: the timing of surgery probably does influence outcome. Br J Neurosurg 2005;19:301-6 PMID: 16455534


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There’s a particular kind of pressure that comes with working in an emergency department, where decisions need to be both swift and sound. Core EM-Emergency Medicine Podcast exists in that space, offering a direct line to the essential knowledge and clinical reasoning that emergency medicine demands. Created by the team at Core EM, each episode feels less like a formal lecture and more like a focused conversation with a trusted colleague. You’ll hear discussions that break down critical topics, from managing common presentations to unraveling complex, high-acuity cases, all grounded in current evidence and practical reality. This podcast serves as a reliable resource for physicians, residents, and advanced practice providers looking to solidify their foundation or stay sharp on the latest evidence. It’s about cutting through the noise to deliver core content that’s immediately applicable at the bedside. Tune in for a clear, concise, and always relevant dive into the principles that define emergency care, designed to fit into a busy clinician’s life between shifts or during a commute.
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