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Acute vs Gradual Onsets of Cauda Equina Syndrome

PUBLISHED ON: November 1, 2018 by Lisa Levine
LAST MODIFIED ON: August 16, 2022
CATEGORIES: Cauda Equina Syndrome, Medical Malpractice

Cauda Equina Syndrome (CES) is a rare, but serious medical condition that occurs when the cauda equina, a bundle of nerves located in the lower back at the base of the spine, becomes damaged. Symptoms can include severe pain in the lower body, numbness and loss of sensation in the saddle area, bowel and bladder dysfunction, weakness in the legs, “foot drop” and sexual dysfunction. Anyone can develop CES, regardless of race or sex. Although CES can happen at any age, it is most often occurs in adults over the age of 30.

If patients with CES don’t receive treatment within 24 – 48 of diagnosis, the results can be devastating: permanent pain and/or numbness, incontinence, sexual dysfunction and even paralysis.

Acute vs Gradual Onsets of Cauda Equina Syndrome

CES can be caused by a number of things, including:

  • Herniated Lumbar Disc
  • Stenosis
  • Infections
  • Tumors
  • Trauma to the lumbar spine
  • Postoperative complications
  • Birth defects
  • Epidurals to the spine – often for pain management

The onset of CES may be acute or gradual. In some patients, symptoms may progress rapidly, while in others they develop gradually over a period of weeks or months.

Acute Onset Of CES: A Medical Emergency

Sudden, acute CES is a medical emergency, like a heart attack or stroke. It can develop in as few as six to 10 hours after symptoms first appear.

Acute CES is characterized by the rapid onset of lower back pain, sensory deficits, motor weakness and bladder or bowel dysfunction. Only immediate treatment, usually surgery, to relieve the pressure on the cauda equina nerve can prevent the symptoms of CES from becoming permanent. That’s why it’s essential for the examining physician to take the necessary steps to confirm a diagnosis of CES.  An MRI (magnetic resonance imaging) or CT scan is the standard method of confirming CES.

Gradual Onset Of CES: More Difficult To Diagnose

Gradual onset CES occurs when compression of the cauda equina nerve takes place over a period of weeks, months or even years. During this time, the patient may experience chronic, recurrent back pain accompanied by signs and symptoms of sensory deficit, motor weakness, and bowel and bladder dysfunction.

The signs and symptoms of the gradual onset of CES are often similar to other lower back conditions, such as sciatica, making it difficult to diagnose the condition in its early stages. Disc herniation of the lumbar disc can be a progressive degenerative process that requires frequent re-assessment to catch the early signs of CES.

Physicians should be aware of the red flags that may indicate a gradual onset of CES, especially urinary and bowel dysfunction and numbness in the perineal area.

Unfortunately, when surgery is delayed for more than 48 hours after symptoms of CES are first diagnosed, the damage done to the cauda equina nerves may be permanent.

Nationwide Cauda Equina Syndrome Attorney

Lisa Levine is a nationally recognized Cauda Equina Syndrome attorney with extensive experience representing clients across the nation in CES medical malpractice litigation. If you are suffering from long-term chronic pain and permanent disabilities due to a misdiagnosis or failure to diagnose CES in a timely manner, you may be able to recover compensation for your pain and suffering, medical bills and economic losses. Contact the law office of Lisa Levine, LLC to schedule a free initial consultation to discuss the circumstances in your case and find out how Lisa can help.

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Primary Office & Mailing Address

2800 Weston Road, Suite 202

Weston, FL 33331

Toll Free: 855.551.8060

Fort Lauderdale Office

110 SE 6th Street, Suite 1700-06

Fort Lauderdale, FL 33301

*All Mail Should Be Sent To Weston Office

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