The cauda equine is a group of nerves at the end of the spinal cord; the group is named for its resemblance to a horse's tail. When the nerve roots are compressed, the result is cauda equine syndrome. Most cases of cauda equine occur after a herniated disc. The syndrome can also be the result of disc degeneration, a fall, automobile accident, tumor, infection or birth defect.
Saddle Anesthesia
The American Academy of Orthopaedic Surgeons states that cauda equine syndrome is often misdiagnosed because many physicians are unfamiliar with the early symptoms. Early symptoms of cauda equine syndrome are similar to other back injuries, such as spinal cord compression, peripheral nerve disorder and compressed spinal nerves. The most noticeable symptom of cauda equine is called "saddle anesthesia." This is altered sensation or numbness to the saddle-like area comprising the inner thighs, back of the legs, over the buttocks and between the legs.
Incontinence
Urinary and/or bowel incontinence can be an early symptom of cauda equine syndrome, as can retention of urine. According to the American Association of Neurological Surgeons, the onset of incontinence is typically recent and usually accompanied by sensory abnormalities in the rectum or bladder, as well as sexual dysfunction.
Motor Weakness
If a physician suspects cauda equine, he will test for motor weakness in the lower extremities. Typically, early motor weakness will consist of muscle weakness, numbness in the feet and weakness in the legs. Reflexes will be diminished, and some muscle wasting will occur in the legs. Patients may stumble or have trouble rising from a chair.
