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Failure To Recognise Cauda Equina Symptoms

Failure To Recognise Cauda Equina Symptoms

Medical practitioners may be unaware of the pattern of symptoms present in an incomplete cauda equina syndrome, meaning a diagnosis is not considered. If this causes an unreasonable delay in treatment, there could be grounds for a compensation claim.

Process of diagnosing and treating cauda equina syndrome

There is a pattern of symptoms that indicate a possible cauda equina syndrome. These are called the red flag symptoms of cauda equina syndrome. They are:

  • Pain and numbness in both legs
  • Urinary difficulties
  • Numbness around the perineum, genitals, anal sphincter and buttocks
  • Leg weakness and tingling

A patient with these symptoms should undergo a neurological examination. This will test whether or not there is normal limb power, altered sensation, absent reflexes and decreased anal tone.

Certain examination findings should increase concern that symptoms are due to compression of the sacral nerve roots. Findings that suggest cauda equina syndrome include:

  • Lack of lower limb power
  • Altered sensation around the perineum, buttocks, legs and anal sphincter
  • Reduced anal sphincter tone
  • Absent ankle reflexes

A patient with the symptoms and clinical signs of cauda equina syndrome must be referred for an MRI scan. The MRI scan request must state the urgency of the situation.

After the MRI scan the patient must be assessed immediately. A spinal practitioner should review the images personally, and if necessary, discuss them with a higher authority such as a radiologist or spinal surgeon.

If the MRI scan confirms a large central disc prolapse is compressing the cauda equina nerves, emergency decompression surgery must be carried out.

Failure to diagnose and treat CES

If the documented symptoms, examination findings and MRI evidence strongly point towards incomplete cauda equina syndrome, the patient should be immediately referred for a same-day surgical opinion.

Sadly this standard of care is not always provided. Sometimes the medical practitioner may fail to recognise the importance of the patient's signs and symptoms, and fail to appreciate the need for immediate referral.

As a result of these failings, there is a delay before emergency referral for cauda equina decompression is eventually made. This could cause long-term injuries, as delayed surgical decompression of the nerve roots is associated with a poor prognosis for recovery.

Typically, clinicians recommend decompression within 48 hours of the development of symptoms. If this does not happen, there is likely to be persisting injuries that could have otherwise been avoided.

Was your care delayed?

If your cauda equina treatment was delayed because medical practitioners failed to understand your symptoms, please get in touch. You could be entitled to pursue a claim for compensation.

Please contact us if you would like to discuss your situation. Please call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.

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