Maya Sushila warns that misdiagnosis of cauda equina syndrome often results from problems with communication, between clinicians and patients, and the cost of subsequent litigation to the NHS can be high.
Thursday 1 October 2020 saw the first annual cauda equina syndrome awareness day. Cauda equina syndrome is a rare condition that affects a group of nerve roots located at the bottom of the spinal cord. Failure to spot a ‘red flag symptom’ and get the right treatment (usually within 24-48 hours) may result in the progression of the condition, including chronic pain, loss of bladder control and the need to use a wheelchair
In this article, Maya Sushila shares that misdiagnosis of cauda equina syndrome often results from problems with communication between patients and their clinician, and she calls on NHS Trusts to support the need for improved recognition of this devastating condition. While, traditionally, attention has been given to building awareness of this condition among GPs, with increased GP appointment waiting times and painful symptoms, it is pertinent that ambulance staff, A&E consultants and neurosurgeons also are reminded of the ‘red flag symptoms’.
Prompt recognition and diagnosis of cauda equina syndrome is dependent upon clinical assessment, including a thorough history and description of the symptoms along with imaging, usually an MRI scan. If left undiagnosed for just 24-48 hours, the condition can have life-changing effects. While patients may feel uncomfortable discussing intimate symptoms with clinicians, delays in treatment and surgery can lead to less than optimal outcomes for the patient and a significant compensation claim of between £200,000 to £2 million against the NHS.
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