Musculoskeletal · UKMLA & AKT
Cauda equina syndrome
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise cauda equina syndrome — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Low back pain - severe; bilateral sciatica is a warning sign
- Saddle anaesthesia - loss of sensation in perineum, perianal area, inner thighs (S2-S4); most specific feature
- Urinary dysfunction - difficulty initiating micturition or loss of urge to void, progressing to painless urinary retention; overflow incontinence is a late sign
- Bowel dysfunction - loss of rectal fullness sensation, faecal incontinence, reduced anal tone on digital rectal examination
- Bilateral lower limb weakness - typically asymmetrical; LMN pattern: flaccid weakness, absent or reduced reflexes
CES produces LMN signs (flaccid weakness, absent reflexes, dermatomal sensory loss) - nerve roots below L1-L2 are compressed, not the cord itself. Hyperreflexia or extensor plantars suggest a higher lesion.
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