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Cauda Equina

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-History
-Examination
-Management

History: features

Sensory
- lumbosacral pain
- bilateral sciatica

Motor
- leg weakness

Sphincters
- reduced sensation of micturition / defaecation
- retention / incontinence
- constipation / incontinence

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Examination: features to elicit

Sensory
- root distribution

Motor
- bilateral leg weakness
- LMN signs (unless also conus compression)

phincters
- saddle anaesthesia
- lax anal tone

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Emergency Management

- Irreversible changes occur after 12 – 24hours
- Urgent MRI lumbar spine (or CT myelography)
- Surgical decompression: partial discectomy

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