Author: rebecca isles

Suspected Cauda Equina Syndrome CES

GIRFT – Pathway

Suspected/Confirmed Cancer – consider Metastatic Spinal Cord Compression (HERE)

1. Red Flags: Has the patient developed any of the following?

  • Difficulty initiating micturition or impaired sensation of urinary flow
  • Altered perianal, perineal or genital sensation S2-S5 dermatomes – area may be small or as big as a horses’ saddle (subjectively reports or objectively tested)
  • Severe or progressive neurological deficit of both legs, such as major motor weakness with knee extension, ankle eversion, or foot dorsiflexion
  • Loss of sensation of rectal fullness
  • Sexual dysfunction (achievement of erection or ability to ejaculate, loss of genital sensation)

If Yes to ANY proceed to 2.

If NO to ALL consider other diagnosis and possibility of GP follow-up

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Adris Razaq

 

Emergency Medicine Consultant and Deputy Director of Medical Education with an interest in Simulation and Ultrasound.

 

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