‘Scan-negative’ cauda equina syndrome: what to do when there is no neurosurgical cause, 2021, Hoeritzauer, Stanton, Carson & Stone

[Andy]

Abstract

Suspected cauda equina syndrome is a common presentation in emergency departments, but most patients (≥70%) have no cauda equina compression on imaging. As neurologists become more involved with ‘front door’ neurology, referral rates of patients with these symptoms are increasing. A small proportion of patients without structural pathology have other neurological causes: we discuss the differential diagnosis and how to recognise these. New data on the clinical features of patients with ‘scan-negative’ cauda equina syndrome suggest that the symptoms are usually triggered by acute pain (with or without root impingement) causing changes in brain–bladder feedback in vulnerable individuals, exacerbated by medication and anxiety, and commonly presenting with features of functional neurological disorder.

Paywall, https://pn.bmj.com/content/early/2021/08/13/practneurol-2020-002830

 

[Trish]

I looked up cauda equina syndrome.
https://www.spine-health.com/conditions/lower-back-pain/cauda-equina-syndrome
It's described here as a medical emergency that presents as severe lower back pain and loss of bladder and bowel control, caused by pressure on the lower part of the spinal cord by, for example, disc prolapse, spinal stenosis or an abscess.

 

[Arnie Pye]

and commonly presenting with features of functional neurological disorder

Naturally, that has to be shoved in to every diagnosis these days. Neurologists can't find the cause so the patients must be mentally ill and making it up.