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At least 433 records · Page 24Linked to original sources
PubMed1984

Electromyographic abnormalities in redundant nerve root syndrome of the cauda equina.

This report documents the seventh patient with redundant nerve root syndrome of the cauda equina in which electromyographic abnormalities were reported. A 79-year-old woman developed low back pain radiating into the left lower extremity. Electromyography (EMG) revealed partial denervation of the left medial gastrocnemius muscle. Metrizamide myelography disclosed a complete block of the spinal canal at the L3 vertebral level, and a coiled nerve root was present behind the L2 vertebral body. Computed tomography showed marked spondylotic narrowing of the spinal canal at the L3 to L4 vertebral level, and spinal stenosis at the L4 to L5 vertebral level. An L3 laminectomy revealed nodular bony overgrowth and ligamentous hypertrophy compressing the dura. Postoperatively, the patient experienced significant pain relief and increased ambulation ability. Electromyographic abnormalities in the left medial gastrocnemius muscle were still present at three- and six-month follow-up.

Aged↗
PubMedDate not supplied

Management of epidural cauda equina disease of prostate cancer by radiotherapy.

OBJECTIVE: Secondary prostate cancer affection of the cauda equina (SPCCE) can be an ultimate cause of morbidity and mortality. Since the results of management of this particular disease condition remain largely unknown, a retrospective case review was undertaken to determine the effects of treatment by radiation in SPCCE patients. METHODS: The records of 12 patients with SPCCE treated at the Division of Therapeutic Radiology during the period 1984 to 1998 were reviewed. The administered total radiation dosage ranged from 6 Gy to 32 Gy (average, 26.6 +/- 2.0 Gy). Two individuals underwent decompressive laminectomy and bilateral orchiectomy at the time of SPCCE and prostate cancer diagnoses. Ten patients had prior hormonal manipulative treatment (orchiectomy, estrogen, or Flutamide therapy). RESULTS: Pain was relieved in three of four symptomatic patients (75%). Five of nine patients unable to walk before therapy could walk after treatment. One of two individuals with anal or bladder sphincter dysfunction improved following irradiation. The overall mean duration of survival was five months. With treatment, survival was approximately three times as long for ambulatory versus non-ambulatory patients. CONCLUSION: We conclude that radiation treatment is efficacious in promoting palliation of SPCCE, although it may not prolong life.

Aged↗
PubMed1998

Cauda equina syndrome after spinal anaesthesia in a patient with severe vascular disease.

PURPOSE: Spinal anaesthesia is selected for many lower extremity surgical procedures each year in the United States with a high degree of safety and efficacy. Even when adverse neurological outcomes have occurred, anatomical abnormality or coagulopathy have been implicated in the majority of cases. Epinephrine is used in high concentrations in many of these anaesthetics to increase the duration and intensity of the block. Although epinephrine is known to decrease spinal cord blood flow, its use in normal patients has not caused complications. We report a case where spinal anaesthesia with bupivacaine and epinephrine resulted in anterior spinal artery compromise and the development of a cauda equina syndrome postoperatively. CLINICAL FEATURES: A 57-yr-old man with severe coronary artery and peripheral vascular disease was scheduled for incision and drain of an abscess of the left thigh. He received an atraumatic dural puncture and injection of 12.5 mg bupivacaine with 0.2 ml 1:1000 epinephrine. During onset, he experienced a severe, painful sensation of the thighs which resolved with development of the block. Postoperatively, he was noted to have exacerbation of proximal muscle weakness and decreased perineal sensation and rectal tone. Subsequent EMG studies demonstrated proximal neuron loss consistent with cauda equina syndrome, presumed to be related to insufficiency of the anterior spinal artery. CONCLUSION: Routine use of epinephrine in spinal anaesthesia for patients with multi-organ vascular disease should be considered carefully because of the possibility of vascular insufficiency of the spinal cord which would be exaggerated by the vasoconstrictive effect of epinephrine.

Anesthesia, Spinal↗
PubMed1984

Sexual dysfunction after spinal cord or cauda equina lesions.

In the neurological follow-up 68 patients with a history of spinal cord or cauda lesions of different aetiology and in different stages of regression were examined and interviewed concerning pre- and postmorbid sexual function. As to sexual dysfunction there was no difference between men and women. There was little relationship between the patients' motor function and their present sexual activity. On the other hand there was a statistically significant relationship between bladder dysfunction and sexual dysfunction. In elderly patients sexual activity was often reduced and also in cases of complete neurological restitution. Stability of the patients' marriage was as in the population on the whole. It is concluded that not only young patients, but also elderly ones, had a need for sexual rehabilitation after treatment for spinal cord or cauda equina lesion.

Adolescent↗
PubMed1998

'Surgiceloma' manifested as cauda equina syndrome.

A 28-year-old man needed urgent decompression because of development of cauda equina syndrome 36 hours after an operation for disk degeneration and spinal stenosis. At reexploration, swollen blood-soaked Surgicel (a hemostatic agent) was found to be the only cause of compression. Six months after the operation, the patient was able to work full time.

Adult↗
PubMed1982

Redundant nerve roots of the cauda equina. A rare disease?

6 cases of so-called redundant nerve roots of the cauda equina are reported, which brings the total number of cases described in literature to 27. The differential diagnosis of the myelographic picture of tortuous filling defects is discussed. The authors believe that the majority of these cases is caused by chronic compression of the nerve roots.

Aged↗
PubMed2002

Selective hypertrophy of the cauda equina nerve roots.

Two patients are described with a previously unreported hypertrophic radiculopathy of the cauda equina with preservation of peripheral nerve function. In one removal of an associated bronchial carcinoid tumour led to marked improvement in the neurological condition suggesting a paraneoplastic cause. The second patient later developed an external ophthalmoplegia but the underlying aetiology remains obscure.

Action Potentials↗
PubMed2005

[Hereditary motor and sensory neuropathy (HMSN) with hypertrophy of the cauda equina and concomitant demyelinating white matter lesions].

Hereditary motor and sensory neuropathy (HMSN) is thought to almost exclusively affect the peripheral nervous system. We report the case of a 48-year-old patient with a longstanding history of HMSN type I who developed signs and symptoms of a cauda equina compression and of a central nervous system relapsing-remitting demyelinating white matter disease. Gross enlargement of the cauda equina fibers was detected by MR imaging of the lumbar spine. Cranial MR imaging revealed demyelinating white matter lesions. This case suggests that peripheral neuropathic mechanisms may also affect the central myelin in HMSN type I.

Charcot-Marie-Tooth Disease↗
PubMed1977

[Myelography in patients with acute cauda equina syndrome (author's transl)].

An emergency myelography was performed on 51 patients with acute cauda equina syndrome. Altogether 23 total obstructions for various causes were found; as well as 13 disc herniations, 2 spinal stenoses and 13 patients with minimal findings in water-soluble myelography. A scheme was developed to analyse the cause of the obstruction and the level of the obstruction in disc herniation cases. The scheme seems to function fairly well, although we have had three errors in the diagnoses of 23 obstructions.

Adolescent↗
PubMed1997

Colonic motility and tone after spinal cord and cauda equina injury.

AIM: To characterize colonic motility and tone in patients with spinal cord and cauda equina injury. METHODS: Barostat-controlled measurements of tone and manometric measurements of phasic contractions in the left colon in two patients with spinal cord injury. ANALYSIS: Computer based analysis of tone and phasic activity; comparison with data from 11 healthy subjects. RESULTS: Both patients showed normal fasting tone and decreased postprandial tone in the colon; one had markedly decreased phasic contractility in the descending colon, but both had normal sigmoid colon motility. CONCLUSIONS: Impaired postprandial tone and phasic motor function of the descending colon after spinal cord injury with normal sigmoid motility suggests regional differences in the effect of denervation. The effect of the level of injury to the neural axis on colonic motor and sensory function requires further elucidation.

Adult↗
PubMed1999

Increased tone of the rectal wall in response to feeding persists in patients with cauda equina syndrome.

The aim was to study fasting and postprandial rectal tone in patients with cauda equina injury. Electromechanical barostat measurement of rectal tone was made in 13 healthy volunteers and in five patients during a 10 min recording, while fasting and for 1 h after a 1000 kCal intake. A prompt decrease of rectal volume was observed in all control subjects and patients. The delay between the end of the meal and the onset of the rectal response was always less than 3 min in the five patients as well as in the control group. The rapidity of the rectal response to feeding observed in our five patients suggests that the rectal response was mediated via a neural or neurohumoral pathway despite severe injury of the sacral parasympathetic supply.

Adult↗