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Cauda equina syndrome (CES) is a condition that occurs when the bundle of nerves below the end of the spinal cord known as the cauda equina is damaged. [2] Signs and symptoms include low back pain, pain that radiates down the leg, numbness around the anus, and loss of bowel or bladder control. [1] Onset may be rapid or gradual. [1]
Common symptoms include lower back pain, headaches, weakness (myasthenia), numbness (hypoesthesia) above and below the involved limb, [2] leg pain, [3] and sometimes rectal and genital pain. [2] Bowel and bladder dysfunction , urinary retention or incontinence may occur. [ 4 ]
Additional symptoms in the legs may be fatigue, heaviness, weakness, a sensation of tingling, pricking, or numbness, and leg cramps, as well as bladder symptoms. [6] Symptoms are most commonly bilateral and symmetrical, but they may be unilateral; leg pain is usually more troubling than back pain.
The nerves that compose the cauda equina innervate the pelvic organs and lower limbs to include motor innervation of the hips, knees, ankles, feet, internal anal sphincter and external anal sphincter. In addition, the cauda equina extends to sensory innervation of the perineum and, partially, parasympathetic innervation of the bladder. [1]
Bladder stone; Cancer of the bladder and prostate; Detrusor muscle weakness and/or instability; Diabetes; Use of ketamine [12] Neurological conditions; for example multiple sclerosis, spinal cord injury, cauda equina syndrome; Prostatitis, including IgG4-related prostatitis [13] [14] [15] Urethral stricture; Urinary tract infections (UTIs) [16]
Among women with chronic pelvic pain, the most common comorbidities are endometriosis (70%), postpartum pelvic pain (44%), bladder pain syndrome (61%) and irritable bowel syndrome (39%).
The predominant symptoms of NC involve one or both legs and usually presents as some combination of tingling, cramping discomfort, pain, numbness, or weakness in the lower back, calves, glutes, and thighs and is precipitated by walking and prolonged standing. However, the symptoms vary depending on the severity and cause of the condition.
Such severe spinal stenosis symptoms are virtually absent in lumbar stenosis, however, as the spinal cord terminates at the top end of the adult lumbar spine, with only nerve roots (cauda equina) continuing further down. [15] Cervical spinal stenosis is a condition involving narrowing of the spinal canal at the level of the neck.