Neurológia pre prax 5/2019
Acute onset urinary incontinence – manifestation of cauda equina syndrome or clinically isolated syndrome?
Cauda equina syndrome is complex neurological syndrome most often caused by extradural compresssion of the lumbar and sacral spinal roots due to acute medial disc herniation. Typical clinical symptoms are radicular pain, saddle hypoesthesia, anesthesia or paraesthesia, sphincter dysfunction, weakness of the lower extremities and impaired low reflexes. Cauda equina syndrome could manifest incompletely and asymmetric disability is frequent. Multiple sclerosis (MS) is progressive autoimmune chronic inflammatory disease of the central nervous system triggered by environmental factors in a genetically predisposed individual. MS attack can affect all parts of the central nervous system. Voiding disorders are the only one symptom at the onset of the disease in 2 % of patients while they are found in 50–97 % of patients in a fully developed MS. This article points to possible issues in the differential diagnosis of these two diseases.
Keywords: urinary incontinence, spinal disc herniation, cauda equina syndrome, multiple sclerosis
