Cauda equina syndrome

Good patient/clinician communication is crucial, with the clinician asking tailored questions to gain key information about symptoms of suspected CES:

• Make sure that the patient understands the seriousness of CES and the importance of timely diagnosis and treatment.

• Use patient-centred language and non-medical lay descriptions; be aware that terms such as ‘saddle anaesthesia’ or ‘recent onset of sexual dysfunction’ will not be understood by some patients.

• Listen carefully to what the patient is saying, so that important information is not missed.

• Provide the patient with written information, if possible, as well as links to good web-based information.

• Be aware that pain is often the most significant symptom for patients, and may distract attention from other, possibly subtle, symptoms indicative of CES, such as altered sensation.

A toolkit for use with patients considered to be at risk of developing CES has been developed.[20]Greenhalgh S, Truman C, Webster V, et al. Development of a toolkit for early identification of cauda equina syndrome. Prim Health Care Res Dev. 2016 Nov;17(6):559-67. https://www.cambridge.org/core/journals/primary-health-care-research-and-development/article/development-of-a-toolkit-for-early-identification-of-cauda-equina-syndrome/4411BF5AD60AABFAF5CE9D6532F35B7D http://www.ncbi.nlm.nih.gov/pubmed/27098202?tool=bestpractice.com

Instruct patients who may be at risk of developing CES about what they should do if symptoms develop, progress, or recur.[12]United Kingdom Spine Societies Board. Early recognition of cauda equina syndrome a framework for assessment and referral for primary care/MSK interface services. Jul 2022 [internet publication]. https://www.ukssb.com/nbpcn-ces-framework