The Cauda Equina nerves are the communication gateway between the brain and the bowel.  If these nerves suffer an injury or trauma, it can have devastating effects on the function of the bowel.

What to look our for

The effects on the bowel can range greatly between mild and complete loss of normal function.  It is important to realize what is normal for you, and to look out for any changes to this.  Bowel disturbance could mean any small or large degree of incontinence or constipation.  Some people may be affected with immediate dysfunction, for others it could be a gradual loss of function over time.

It is important to note that it is possible to have CES without suffering from bowel dysfunction.  Other red flag signs and symptoms might take prominence.  Alternatively you might experience loss of sensation when passing a bowel motion, which can be another indicator of CES.

Incontinence or constipation are the two most obvious signs that your bowel function has changed for the worst.  Incontinence is the loss of control over your bowel movements, whilst constipation is difficulty in passing a bowel motion.

What to do

If you are concerned by change in your bowel function, as with other red flag symptoms, speak to your doctor.  It is important that if you are affected in this way you should seek immediate medical advice.  Especially if symptoms are in tandem with back problems or back pain.

Because of the seriousness of Cauda Equina Syndrome, do not hesitate to contact your GP or your nearest A&E department.  An urgent MRI scan is required to rule out CES.  It is vital that, should CES be found, decompression surgery is performed as soon as possible.  It is said that surgery within the first 48 hours of the onset of symptoms will achieve the best prognosis.

In the worst cases, the symptoms can become permanent – even after successful surgery to repair or replace the prolapsed disc.  This can be life-changing.  If you are feel that your concerns were not taken seriously at an early stage then you might be able to follow up with legal action.  Compensation can help pay for any financial loss such as not being able to work or ongoing rehabilitation treatment.

Get in touch with us today for specialist legal advice.

What is a misdiagnosis?

A misdiagnosis occurs when a doctor or other health care professional advises that a patient has an illness or condition but it later transpires such diagnosis was incorrect. Therefore a misdiagnosis may also describe a situation whereby there has been a lack or delay of a diagnosis leading to no treatment, incorrect treatment or delayed treatment.

Cauda equina syndrome is rare which unfortunately means there is a general lack of awareness and understanding of the condition and the red flag signs and symptoms. When cauda equina syndrome is misdiagnosed, it can result in very severe and far reaching physical, mental and financial consequences for a patient. 

Cauda equina syndrome can be misdiagnosed by a range of health care professionals including GPs, doctors and/or nurses at walk-in or out-of-hours centers and even doctors in A&E or hospital. 

How can cauda equina syndrome be misdiagnosed? 

The red flag signs and symptoms of cauda equina syndrome include saddle anesthesia, bladder disturbance, bowel disturbance, sexual problems and nerve root pain. Healthcare professionals should be aware that such red flag signs and symptoms are suggestive of a potential diagnosis of cauda equina syndrome which warrants further investigation. However, sometimes a healthcare professional can miss or fail to recognise the signs and symptoms which can then lead to a misdiagnosis. 

A doctor should conduct certain physical tests and examinations if a patient presents with any of the above red flag signs and symptoms. This should include a MRI scan of the spine.  

A misdiagnosis can also occur when a medical professional has failed to take a detailed medical history from a patient including details of when symptoms began and how they have progressed since their initial onset. This would include discussing things such as any changes in function and the development of new or unusual symptoms.  

Common misdiagnoses of cauda equina syndrome include:

• Generalised lower back pain and / or sciatica – one of the main symptoms of cauda equina syndrome can be severe pain in the lower back which often radiates through the buttocks, down the legs and into the feet. 
• Urinary tract infections – cauda equina syndrome can cause problems with bladder and/or bowel function, such as a change in flow, inability to go to the toilet or incontinence. 

Can I make a medical negligence claim if I have been misdiagnosed?

If you have attended upon a health care professional displaying symptoms of cauda equina syndrome and was misdiagnosed, you may be able to make a medical negligence claim for financial compensation.

Our specialist team can offer advice on a no-obligation basis. After having an initial consultation with you, our team will assess whether you may have a potential medical negligence claim.

If you then decide that you would like to proceed with a claim we have a range of funding options available including a No-Win, No-Fee Agreement supported, if appropriate, by legal expenses insurance. 

Do not delay – contact us now to see if you have a potential medical negligence claim. 

Cauda Equina Syndrome is a rare but very serious and life changing medical condition. There are several red flag signs and symptoms which if a patient presents with to their GP or other health care professional, should lead them to consider a very serious condition with potential to require immediate medical attention.

Unfortunately, there is a lack of understanding and awareness among the medical profession about the red flag signs and symptoms of Cauda Equina Syndrome. The consequences of this are that patients can suffer a delay in diagnosis and treatment, resulting in poorer outcomes and life changing injuries.

A patient suffering Cauda Equina Syndrome may present with one of, or a combination of the following red flag signs & symptoms:

1. Saddle Anaesthesia;
2. Bladder disturbance;
3. Bowel disturbance;
4. Sexual Problems;
5. Nerve root pain.

 
There are various presentations of the above signs and symptoms and it is vital that when speaking with healthcare professionals they are aware of any change experienced by a patient and when the patient noticed a change occurred.
 
For example, saddle anesthesia can affect individuals in different ways and a patient may experience only one or a combination of the following problems:

• Loss of feeling between the legs;
• Numbness in the genital and back passage area;
• Reduced sensation or complete loss of being able to feel oneself wipe when going to the toilet;
• Weakness or tingling in the saddle area.

 
If a patient experiences any of the above red flag signs or symptoms, they should seek urgent medical advice from their GP or nearest hospital. It would also be worthwhile mentioning any concerns about Cauda Equina Syndrome to your GP or hospital.
 
Can I make a medical negligence claim if there has been a delay in diagnosing and treating Cauda Equina Syndrome?
 
If you have attended upon a treating clinician displaying any of the red flag signs and symptoms of CES and were not urgently referred to an appropriate clinician or hospital for investigations and treatment, you may be able to make a medical negligence claim for financial compensation.
 
Our specialist team can offer advice on a no-obligation basis. After having an initial consultation with you, our team will assess whether you may have a potential medical negligence claim.
 
If you then decide that you would like to proceed with a claim we have a range of funding options available including a No-Win, No-Fee Agreement supported, if appropriate, by legal expenses insurance.
 
Do not delay – contact us now to see if you have a potential medical negligence claim.

Cauda Equina Syndrome (CES) is a rare and very serious condition. Regardless of how CES occurs, it is vital that any patient is treated as a surgical emergency.
 
Located within your spine are various nerve roots which are responsible for sending and receiving signals or messages to different parts of your body.
 
The area relevant to CES is just above the waist which is approximately where the spinal cord ends. The group of nerves in this region are called the Cauda Equina.
 
The Cauda Equina are responsible for the supply of nerves to the lower limbs, bladder and bowels. They also supply sensation to the skin around the back passage and bottom (otherwise known as the perineal area).
 
CES occurs when the nerves are compressed which can result in an individual suffering from one or more of the red flag signs and symptoms including bladder and bowel dysfunction, saddle anaesthesia, sexual dysfunction and nerve root problems in the lower limbs.

Here of some of the ways CES can occur:

• Large lower lumbar disc herniation – this is usually compression of the discs at the L4/L5 and L5/S1 area. The NHS describes a herniated disc as being a “slipped disc” which occurs “when a soft cushion of tissue between the bones in your spine pushes out”. This is said to be the most common way CES can occur.

• Congenital – a patient may have a congenitally narrow spinal canal (through problems such as spina bifida) or may have acquired spinal stenosis (narrowing of the spaces within your spine).
• Tumours – such as metastases, lymphomas and spinal tumours.
• Trauma resulting in injuries such as fractures.
• Infection – including circumstances where an abscess may form either within the spinal canal or by pressing on the Cauda Equina.
• Post operative complications such as a haematoma. A haematoma is a solid swelling of clotted blood within the tissues. Such a complication can occur following a spinal anaesthetic.

 
The above is not an exhaustive list.
 
Irrespective of how CES occurs, the red flag signs and symptoms of CES remain the same and urgent medical advice and treatment should be sought from your GP or local A&E department.
 
If you are suffering CES, then your clinician should make an urgent referral for further investigations and treatment. 

If you have attended upon a treating clinician displaying symptoms of CES and were not urgently referred to an appropriate clinician or hospital for investigations and treatment, you may be able to make a medical negligence claim for financial compensation.

Our specialist team can offer advice on a no-obligation basis. After having an initial consultation with you, our team will assess whether you may have a potential medical negligence claim.

If you then decide that you would like to proceed with a claim we have a range of funding options available including a No-Win, No-Fee Agreement supported, if appropriate, by legal expenses insurance.

Do not delay – there can be a time limit affecting your right to claim, so contact us now to see if you have a potential medical negligence case.

The onset of Cauda Equina Syndrome may be sudden, within hours or sometimes gradual over weeks or months. No matter how a patient may develop Cauda Equina Syndrome, it is imperative that it is diagnosed and treated as early as possible. Therefore, it is extremely important that patients are referred urgently to appropriate medical professionals who can confirm a diagnosis of CES and provide urgent treatment – usually surgery.

Some medical professionals distinguish different stages of CES as follows:

CES-S
This means CES suspected or suspicious. A patient may show symptoms such as bilateral radiculopathy which may feel like the nerves have been pinched and can result in pain, weakness, numbness, or difficulty controlling specific muscles, particularly the legs.

CES-I
This means CES incomplete. If the CES is incomplete, a patient will generally have urinary difficulties of neurogenic origin including altered urinary sensation, difficulty urinating which could be a poor flow or perhaps feeling like you want to urinate but cannot and loss of feeling that you need to urinate. There may also be loss of sensation in and around the saddle and genital area. 

CES-R
This means CES retention and generally means that the CES is complete. Usually, a patient will have issues including urinary retention without being aware of such a problem as there can often be no pain associated with the retention and complete loss of control of the bladder. A loss of sensation around the saddle and genital area is usually full or extensive at the very least.

It is vital that patients are urgently referred to a suitable medical professional at the CES-S and at the latest, the CES-I stage. The later a patient waits for a referral and subsequent treatment, the worse a patients outcome and recovery is likely to be.

Patients at the CES-S and CES-I stage should be referred urgently for a MRI scan of the spine as this will help to identify whether a patient has CES and the likely cause.

It is vital that the referral is urgent as patients can deteriorate to CES-R rapidly. 

Can I make a medical negligence claim if I have not been urgently referred?

If you have attended upon a treating clinician displaying symptoms of Cauda Equina Syndrome and were not urgently referred to an appropriate clinician or hospital for investigations and treatment, you may be able to
make a medical negligence claim for financial compensation.

Our specialist team can offer advice on a no-obligation basis. After having an initial consultation with you, our team will assess whether you may have a potential medical negligence claim.

If you then decide that you would like to proceed with a claim we have a range of funding options available including a No-Win, No-Fee Agreement supported, if appropriate, by legal expenses insurance.

Do not delay – contact us now to see if you have a potential medical negligence claim.

Cauda Equina Syndrome is a surgical emergency. Once a patient has been diagnosed with the condition, they should undergo surgery within 48 hours. If Cauda Equina Syndrome is not diagnosed or treated in a timely manner, patients can suffer devastating physical, psychological and financial consequences which may have otherwise been avoided.

If you feel let down by a health care professional, whether this is your GP, a hospital or private surgeon, you should consider taking legal advice regarding a medical negligence claim.

It is important to understand that you will have to speak about the substandard treatment you received and your resulting injuries and disabilities which you may find traumatic and upsetting. However, your case will be confidently handled by our team of solicitors who are sympathetic and knowledgeable about your situation.

It is important to understand that the only legal remedy available is compensation. We cannot discipline a healthcare professional, force a hospital or individual healthcare professional to change how they work or make a healthcare professional or organisation say sorry to you.

If you are an adult with mental capacity to bring a legal claim, you must do so within 3 years from when the alleged medical negligence occurred or when you first realised that you’d suffered injury.

In the case of young people aged under 18, the 3 year limit does not start to run until their 18th birthday. Put simply, they have until their 21st birthday to bring a legal claim. Normally, a parent or other person close to them can make a claim on their behalf until they attain the age of 18 when the person may want to continue the claim them self.

If the claim is for an individual who cannot manage their own affairs because of a mental disability, the strict 3 year time limit may not apply.  A spouse, parent or other person close to them can make a claim on their behalf but should do so as soon as possible on their behalf.
 
It is best to take legal advice as soon as possible as Cauda Equina Syndrome is a serious condition and a medical negligence claim may take sometime to investigate.

If you are concerned that you do not have the funds to pursue a medical negligence claim do not worry.

Our specialist team can offer advice on a no-obligation basis. After having an initial consultation with you, our team will assess whether you may have a potential medical negligence claim.

If you then decide that you would like to proceed with a claim we have a range of funding options available including a No-Win, No-Fee Agreement supported, if appropriate, by legal expenses insurance.

Do not delay – contact us now to see if you have a potential medical negligence claim.

Colin unfortunately suffered from Cauda Equina Syndrome on two occasions.

Colin woke early one morning with debilitating back and leg pain. Colin recognised the severity of the pain as being associated with Cauda Equina Syndrome, as he had been treated for the condition ten years before.
 
Colin had recovered from his previous Cauda Equina Syndrome although he had been left with some bladder symptoms. Colin therefore knew how important it was to obtain a quick diagnosis and undergo emergency surgery.
 
Colin attended his local Accident and Emergency department and informed staff that he was suffering with Cauda Equina Syndrome. 
 
Colin knew that he needed an MRI scan and surgery within 48 hours from the onset of his symptoms however, he was informed that MRI scanning would not be available over the weekend. Colin was reassured that the staff knew what they were doing and was told to ‘calm down’.
 
Colin did not undergo an MRI scan until 55 hours after the onset of his symptoms, by this time, it was too late and Colin was to be left with permanent disabilities.  
 
Once Colin underwent the MRI scan, he was immediately transferred for surgery at another hospital. The surgeon was experienced in treating Cauda Equina Syndrome and was surprised at the delay Colin experienced and drafted a letter to Colin’s local hospital, to highlight his concerns.
 
Colin underwent arduous rehabilitation for 10 weeks and made a complaint to his local hospital however, they responded to say that they were ‘not to blame’. Colin was annoyed and concerned at the hospital’s response.
 
Colin contacted Ian Sprakes, Head of the Clinical Negligence department at Bridge McFarland. Ian represented Colin to get the justice that he deserved. Colin received £1.32 million in compensation.
 
Colin was left with bowel and bladder problems, mobility difficulties, muscle wastage and chronic pain as a result of the delay in his diagnosis and treatment.
 
Colin felt that Bridge McFarland "dealt with my case fantastically. In fact, it couldn’t have been done any better”.