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PubMed1979

[Restoration of motor functions in disruption of the spinal cord or cauda equina].

Eight patients with a rupture of the spinal cord at the level of middle thoracic vertebrae or cauda equina at the lumbar level showed partial recovery of motor functions. The development of the activity was revealed by electromyography in body muscles and M. gluteus media in all the patients who attempted voluntary movements. Appearance and development of the activity was also observed in the muscles of the femur and crus. The level of rehabilitation shown by the patients was high enough. They could walk in fixation apparatuses, returned to their occupational activities and could practice self-service. The motor functions recovered more rapidly at the low levels of injury; however, the same and possibly complete rehabilitation was attained in 2 patients with a higher level of injury. The mechanism of the function recovery is underlain by the compensatory development of activity in the muscles of the body and capacity of the distal strip of the spinal cord for elaboration of new motor reactions in which the muscles of the extremities participate.

Cauda Equina↗
PubMed1984

Clinical correlation of urodynamic findings in patients with localized partial lesions of the spinal cord and cauda equina.

Urodynamic studies were undertaken in 70 patients with incomplete, confirmed, localized lesions involving the spinal cord and cauda equina, irrespective of clinically evident bladder disturbances. Both detrusor and urethral function were simultaneously evaluated and correlated with neurological deficits and symptoms of lower urinary tract dysfunction. It was evident that in those patients with localized spinal cord lesions, lower urinary tract disturbances were closely associated with disturbances of pinprick sensation. Clinically silent bladder and sphincter dysfunction was encountered in 14% of the patients, and the number of asymptomatic patients was significantly higher among those with upper motor neuron lesions. Incontinence was associated predominantly with conus lesions; however, the other symptoms had no relationship to the site of the lesion. Symptoms such as urgency, incontinence, and nocturnal incontinence were associated with detrusor hyperactivity, and urinary retention was associated with urethral overactivity and dyssynergia. The urodynamic findings could explain the pathogenesis of the symptoms in most instances, but were not necessarily related to them. It is concluded that the pathways subserving lower-urinary-tract function are closely associated with the pathways subserving pinprick sensation, and that a lesion along the spinal axis can affect the bladder, sphincter, or both in a variety of ways, thus leading to the widely variable clinical findings associated with neurogenic lower urinary tract dysfunction.

Adult↗
PubMed2004

Cauda Equina Syndrome as a Clinical Presentation of Primary Angiitis of the Central Nervous System (PACNS).

Primary angiitis of the central nervous system (PACNS) is a form of vasculitis affecting the central nervous system (CNS) that is not associated with systemic disease or vasculitis outside the CNS. It is a rare disease with significant morbidity and mortality. Delay in diagnosis and treatment is common due to its nonspecific clinical symptoms and lack of efficient noninvasive diagnostic tests. The finding of vasculitis in the leptomeningeal and cortical biopsy sample has remained the gold standard for making the diagnosis of PACNS. We describe a patient whose clinical symptoms of cauda equina syndrome led to a nerve root biopsy that was consistent with PACNS despite prior extensive investigations including a brain biopsy. This report highlights the cauda equina syndrome as a clinical presentation of PACNS and emphasizes the need for awareness of this rare condition.

Journal Article↗
PubMed1978

Redundant nerve roots of the cauda equina.

Two cases of redundant nerve roots syndrome are presented. Both cases displayed coiled and elongated nerve roots of cauda equina, associated with proliferated fibrous tissue on the ligamentum flavum or with spondylosis and disc protrusion compressing the caudal dural sac. The pathogenesis of the syndrome of redundant nerve roots is briefly discussed.

Adult↗
PubMedDate not supplied

Neuroendocrine tumor (paraganglioma) of the cauda equina: MR and pathologic findings.

The MR and pathologic features of a case with neuroendocrine tumor (paraganglioma) of the cauda equina are presented. MR showed the tumor to be hyperintense on postcontrast examination and also showed serpiginous flow voids suggesting vessels capping the tumor. A neuroendocrine tumor should be considered in the differential diagnosis of tumors in this location.

Adult↗
PubMed1976

Extradural extrusion of roots of the cauda equina.

For lumbar spondylotic stenosis causing progressive disability, multiple laminectomy was about to be completed. Suddenly roots of the cauda equina herniated through the myelography puncture site in the dura mater, resembling redundant nerve roots. This case is being reported not only because such sudden extradural extrusion is rare, but also to raise the question of the relationship of redundancy of nerve roots to spondylotic stenosis.

Aged↗
PubMed1984

Equine adenovirus 1 isolated from cauda equina neuritis.

Equine adenovirus 1 was recovered after four to six passages from two out of three cases of cauda equina neuritis (CEN) using kidney monolayers. Similar treatment of lumbo-sacral spinal cord from six normal horses did not yield adenovirus. All three cases of CEN had antibodies to the neuritogenic myelin protein P2 while immunofluorescence demonstrated that autologous IgG bound to the myelin of affected nerves. Adenovirus was not detected in neural tissue by immunofluorescence.

Adenoviridae↗
PubMed1983

Detrusor hyperreflexia in neurogenic bladder disorders caused by localized partial lesions of the spinal cord and cauda equina.

In 70 patients studied by cystometry, detrusor hyperreflexia seen with localized partial lesions of the spinal cord and cauda equina could be differentiated into two types. In one type, in which the hyperreflexia was of a reflex nature and bladder compliance was unchanged, the detrusor contractility was described as compliant hyperreflexic. In the other type, in which the contractions were of a rhythmic nature and accompanied by reduced compliance, the contractility of the detrusor was described as noncompliant hyperreflexic. The compliant hyperreflexic contractions correlated well with signs of upper motor neuron disturbance, the noncompliant hyperreflexic contractions with lower motor neuron disturbance.

Adult↗
PubMed1997

[Neurinomas and ependymomas of the cauda equina. A review of the clinical characteristics].

A retrospective review of 603 cases of intradural benign tumors of the cauda equina are presented (283 schwannomas and 320 ependymomas). For each tumor, the clinical course and long-term postoperative results were analyzed: it emerged that differential diagnosis between neurinomas and non tumoral lesions is not possible if based on clinical findings alone and that neuroradiological diagnosis is more accurate when MRI is employed. Long-term prognosis of neurinomas was always favourable, while in the ependymomas, early diagnosis gives excellent results because prognosis is apparently directly correlated to the length of preoperative clinical history.

Adolescent↗
PubMed1994

Neurinoma of the cauda equina misdiagnosed as prolapsed lumbar disk. Report of three cases.

The authors report three cases of neurinoma of the cauda equina initially misdiagnosed as prolapsed lumbar disk. Computed Tomography failed to reveal the tumour, while showing evidence of disk-degenerative patology and being thus misleading. Similar cases are reported in literature. After a thorough analysis of the causes of such an apparently gross error, it is concluded that the main source of pitfalls arises from neglecting those typical clinical features differentiating prolapsed disk from oncogenetic sciatica. When oncogenetic sciatica is suspected Computed Tomography is inappropriate and even misleading, while the elective investigation is Magnetic Resonance.

Adult↗
PubMed1990

[Clinical and experimental studies on ascending cauda equina action potential (A-CEAP) in lumbar lesion with reference to positivisation].

The phenomenon of positivisation in ascending cauda equina action potential (A-CEAP) was evaluated in 114 patients with lumbosacral lesions. These patients were divided into two groups, i.e., non-positivisation and positivisation group. In the former, positive wave ratio was highest at the L5/S upon stimulating the peroneal nerve. In the latter, the positivisation at the L4/5 upon stimulating the peroneal nerve spread not only to the cranial level but also to the caudal-L5/S level. Based on these experimental results, the factors causing positivisation in the L5/S level without lesion were: 1) curving effect of the L5 nerve root, 2) augmentation of current density within the spinal canal and 3) the amount of individual impulses propagating along the L5 and S1 root.

Action Potentials↗
PubMed2000

Cauda equina tumors: a French multicenter retrospective review of 231 adult cases and review of the literature.

Large series of cauda equina tumors in adults are seldom reported. This French series retrospectively reviews 231 cases collected for the congress of the Societe Francaise de Neurochirurgie in 1996. The authors first analyze this series and then discuss the pertinent literature. Schwannoma was the most frequent benign tumor in this series, followed by ependymoma. Very few malignant tumors were recorded; these were usually malignant neurinomas nearly always in neurofibromatosis patients. Some other rare tumors were also recorded, including paragangliomas. This series confirms the importance of the pretherapeutic neurological status in functional prognosis. All schwannomas can be cured, while ependymomas and paragangliomas may recur after a very long delay. Surgery must be as complete as possible, since adjuvant therapies are proven to have little efficacy. This type of tumor requires very long follow-up. Prognosis is good for hemangioblastomas. Sphincter dysfunctions carries a poor prognosis and may appear after primary surgery, more often after treatment of recurrences.

Adult↗
PubMed1989

[Electromyography and spinal evoked potentials in cauda equina syndrome of dogs].

In order to investigate usefulness of electrodiagnostic methods in Cauda Equina-Compression, 26 dogs with this disease were subjected to electromyography and spinal evoked potentials. 16 normal dogs served as controls. It was found that--after stimulation of the Nn.tibialis, peronaeus, pudendus and coccygeales and recording at the lumbosacral junction--latencies and nerve-conduction velocities were largely normal. However the amplitudes were decreased and--depending on the severity of the compression--the morphology of the potentials was altered although considerable standard deviations were obtained. Electromyographically, increased spontaneous activity with fibrillations and positive sharp waves were found in the myotomes of the lumbosacral nerves. Their number increased according to the severity of the cauda equina compression and they had a centrifugal distribution pattern. Based on these results it appears indicated to perform an electromyographic exam before applying myelography. The technique of spinal evoked potentials will need more refinement and standardisation before being useful in a clinical situation.

Animals↗
PubMed2004

Cauda equina syndrome in patients with low lumbar fractures.

OBJECT: Symptoms of cauda equina syndrome (CES) can include low-back pain, sciatica, lower-extremity weakness, sensory deficit, perineal hypesthesia or anesthesia, and loss of bowel or bladder function. Several causes of the syndrome are recognized, but its optimal treatment remains controversial and has been broadly based on data gathered from series involving herniated discs. Information on the treatment of CES caused by low lumbar traumatic injuries has not been well documented. METHODS: Between January 2000 and December 2003, 17 consecutive cases of CES caused by low lumbar traumatic injuries at L2-5 were identified. The traumatic injuries consisted of gun shot wound in two cases, motor vehicle accident in 11, and a fall from height in four. Conus medullaris injuries causing CES were excluded from this review. Presenting symptoms, mechanisms of injury, radiographic images, timing of surgery, surgical approaches, and neurological status at the final follow up were documented. All patients underwent follow up of at least 12 months. Fourteen of 17 patients had satisfactory outcomes. Despite undergoing surgery within the first 24 hours postinjury, three patients had what was classified as a poor outcome given their residual deficits and included two cases with gunshot injuries. Recovery of leg weakness occurred within 4 months, whereas bladder and bowel function recovered within 3 months. All patients in this series underwent decompression within less than 48 hours after syndrome onset. Overall, the authors found no difference regarding timing of surgery between patients in the satisfactory outcome group and those in the poor outcome group. CONCLUSIONS: Based on the evidence in this study, the severity of a patient's condition on initial presentation is the most crucial factor in predicting outcome following CES due to low lumbar injuries. Although the matter of the timing of surgery remains controversial, the authors of this study recommend that surgery be performed within 48 hours of syndrome onset.

Adolescent↗
PubMed1984

Paraganglioma of the cauda equina. A histologic, immunohistochemical, and ultrastructural study and review of the literature.

We report a case of paraganglioma of the cauda equina and filum terminale. Diagnosis was established by the histologic organoid pattern, immunohistochemical staining for neuron-specific enolase and ultrastructural dense-core neurosecretory granules. A survey of the literature yielded 16 previously reported cases, five of which were described in 1983. This suggests that heightened awareness of this entity will result in a corresponding increase in the reported incidence.

Cauda Equina↗
PubMed1986

Syringomyelia and syringobulbia associated with an ependymoma of the cauda equina involving the conus medullaris: case report.

A patient with syringomyelia and syringobulbia secondary to an asymptomatic ependymoma of the cauda equina involving the conus medullaris is described. Delayed metrizamide computed tomography myelography was decisive for making the diagnosis of a highly extended syrinx associated with the tumor. Syringomyelic symptoms improved remarkably following the removal of the tumor, and the syrinx was not visualized in a postoperative study. The pathogenesis of syringomyelia associated with a caudally located spinal cord tumor is discussed.

Adult↗