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Emergency Medicine Cases

Best Case Ever 11: Cauda Equina Syndrome

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7602 Ratings

🗓️ 6 September 2012

⏱️ 6 minutes

🧾️ Download transcript

Summary

As a bonus to Episode 26 on Low Back Pain Emergencies with Dr. Brian Steinhart & Dr. Walter Himmel, we have Dr. Walter Himmel's own personal incredible case of Cauda Equina Syndrome. In the related Episode we will cover the most serious spinal and vascular causes that present with low back pain including Cauda Equina Syndrome, Spinal Epidural Abscess, Spinal Epidural Hematoma, Metastases to the spine, Abdominal Aortic Aneurysm and Retroperitoneal Hematoma. [wpfilebase tag=file id=394 tpl=emc-play /] [wpfilebase tag=file id=395 tpl=emc-mp3 /]

Transcript

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0:00.0

In anticipation of episode 26 on low back pain emergencies, I've got with us Dr. Himmel,

0:25.0

who's going to give us his best case ever.

0:27.9

Dr. Himmel, let it rip.

0:30.4

Between 2008 and 2010, I had intermittent back pain.

0:35.1

It was felt in the lumpo sacral area.

0:36.8

It was felt like jabs of stabbing pain. It was felt in the lumpo sacral area. It was felt like jabs of stabbing pain.

0:40.9

Somebody had shot me in the back or snouted with a knife.

0:43.7

It would occur after walking, sitting, working, coming and going for two years' time.

0:49.9

Zero satirate pain in my legs, zero other symptoms.

0:53.8

Eventually, they began to get aching in my upper lateral thighs, particularly after physical activity.

0:59.0

I saw a neurologist. I had a cat scan out of my lower back.

1:02.9

The levels that the neurologist specified were L3 to S1.

1:06.4

My cat scan came back absolutely normal.

1:10.6

Oh well, I figured I better stop complaining.

1:13.7

Time went on. Early December of 2010, when I sat more than five minutes, I began getting numbness

1:20.2

in the soles of both feet, relieved by standing your leg flat on my back. At work, whenever I bent over to insubate somewhere,

1:28.6

took something off the ground,

1:29.5

I did jolts of knife-like pain in my lower sample back as if I'd been stacked.

1:33.8

I'd have to hold out to the tabletop, and the pain would disappear.

1:37.3

I sat down, now I'm going to so go with my feet.

1:40.0

Went out for two or three weeks.

1:42.4

And then on a Saturday morning before a shift,

...

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