Our Clinical Negligence team has over 30 years' experience in Cauda Equina Syndrome Claims. Our Clinical Negligence solicitor, David Dickie, explains the subclassifications.
Detailed below are some of the terms you might hear when professionals are discussing Cauda Equina Syndrome.
Cauda Equina Syndrome Suspected or Suspicious
CESS (CES suspected or suspicious). Bilateral radicular problems: bilateral radicular pain (and/or bilateral radicular sensory disturbance, motor weakness or loss of reflexes). Patients with bilateral radicular leg pain do not have a cauda equina syndrome at that time, but they are at increased risk of developing a cauda equina syndrome.
Cauda Equina Syndrome Incomplete
CESI – the incomplete cauda equina syndrome (CESI) where there are subjective symptoms or objective signs of a cauda equina syndrome but the patient retains voluntary control of micturition. One definition of CESI is “a patient with urinary difficulties of neurogenic origin, including altered urinary sensation, loss of desire to void, poor urinary stream and the need to strain in order to micturate”. Broadly, patients who are treated when they are CESI do well, exactly how well depends on the specific nature of the problems that the individual patient has at the time of treatment.
Cauda Equina Syndrome Retention
CESR – the cauda equina syndrome with neurogenic retention of urine (CESR). Such patients have objective signs of cauda equina dysfunction and crucially they have a paralysed insensate bladder, i.e. they no longer have executive control of bladder function. The bladder continues to act as a passive store of urine. When bladder capacity is reached there is reflex contraction of the bladder with incontinence. One definition of CESR is “painless urinary retention and overflow incontinence, where the bladder is no longer under executive control”. When one reviews the medical literature in this area there is uncertainty as to whether prompt decompressive surgery after CESR is usually associated with recovery of function, or not.
Cauda Equina Syndrome Complete
To which some might add CESC which is the complete cauda equina syndrome where there is complete loss of all cauda equina function. There is perineal anaesthesia, there is a paralysed, insensate bladder, there is a paralysed, insensate bowel and the anal sphincter is patulous. This ultimate stage of CES is associated with a very poor prognosis regardless of treatment.
How We Can Help
Our team of specialist Clinical Negligence Solicitors specialise in this area and have achieved substantial settlements for clients as a result of successful litigation. For more information on pursuing a claim, please contact the team on freephone 0800 011 6666 or via email at legal@timms-law.com.
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