Cases for finals #5 – Examination

Speech normal

HMF – normal

Cranial nerves – normal

ULs – normal

  • LLs
  • tone – normal
  • power – severe weakness of KF; ADF; APF
  • reflexes – reduced KJs; absent AJs
  • sensation – saddle anaesthesia; PR exam – reduced anal tone

Oddly, for a “spinal cord” problem, the signs are all “peripheral” – flaccid weakness, lost reflexes, loose anal tone. This is because the lesion doesn’t knobble the spinal cord but rather the peripheral nerves, before they break free from the shackles of the spinal column and make it into your feet, buttock and rectum (delightful image that).

As such, you get peripheral signs from a central lesion – usually a prolapsed disc.

Image result for cauda equina syndrome

Management is surgical and urgent. Straight to a scanner please and call your friendly spinal person for advice.

Image result for cauda equina syndrome mri

Don’t understand? Go to the spinal part of the neuro-anatomy lecture for more (about half way through).

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: