It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Spinal Cord Disorders Message Board

  • Cauda Equina Symptoms with no clear etiology

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 02-05-2005, 12:59 PM   #1
    Woofdog123
    Junior Member
     
    Join Date: Nov 2003
    Posts: 17
    Woofdog123 HB User
    Cauda Equina Symptoms, nerve damage area found

    Hi, I have an unusual problem which has my doctors stumped, and wonder if anyone here has seen something similar or has ideas.

    Lower back injury, lifting, caused great pain in sacrum around S2or s3 level. a few months later, leaning back in barber wash chair (extension from sitting position) caused terrible pain in nearly same place (sacrum), and caused penis and perineum to go numb and suffer loss of psychogenic erectile function. Pain calmed down after a week, numbness/er. func. normalized gradually after 3 weeks.

    A few months later, similar situation occurred except pain also included pain around L4/5 level, and numbness and erectile dysfunction never went back to normal.

    Since then (23 months ago) there has been one more acute incident, where pain in the sacrum (not the disc area) was accompanied by loss of function which gradually got somewhat better after a week or so.

    tests - I have had nearly all.

    discogram shows grade 5 tear at L4/5, did NOT reproduce pain in sacrum, did repr. pain at L4/5 level
    mri shows bulge L4/5, making slight anterior impression on thecal sac. Probably a dozen spine specialists have looked at this and conclude there is no compression.
    myelogram - negative in lumbar spine, they did NOT do ct of the sacrum below S1 bone.
    pudendal nerve test shows right 4.2ms, left 2.7ms, consistent with less sensation on right than left
    examination shows partial numbness in right S3, 4, 5 dermatomes, left S3. urinary frequency altered, some loss of defecation sensation right side as well. dermatomes include those NOT ennervated by pudendal nerve components.
    MRI of the entire spine (brain to pelvis) otherwise negative, except for protrusion at posterior S2 bone which makes mild to moderate encroachment. radiologists are dismissive of this feature though it is very close to my pain location in sacrum.

    i have herpes simples 2, genital. postulated that herpes is one element in a double-crush nerve injury, but clearly there is a lower back element.

    standing, prolonged sitting make problem worse, sleeping/lying on back somewhat better, lying on side much better. the effect standing has on an erection is nearly instantaneous, while I still have nocturnal.morning erections, just standing up can take one down in 20 seconds. In general flexion seems to improve sensory function near-instantaneously in the affected dermatomes.

    I am at a loss, my doctors are at losses, and my condition continues to degrade. Any ideas on what to look for that might explain this? My possible targets are discogenic referred problem, which many don't believe would just be numbness (I have no pain in perineum), or some mechanism whereby inflamation and irritation of something in the sacrum also causes this, though no one has any idea what.

    my current efforts include
    another myelogram, this time with attention to sacrum
    bone scan of sacrum looking for any fracture
    any other ideas?

    Last edited by Woofdog123; 02-09-2005 at 08:53 PM. Reason: change of status, new information

     
    Sponsors Lightbulb
       
    Old 02-05-2005, 01:12 PM   #2
    misery
    Senior Member
    (female)
     
    Join Date: Jan 2005
    Posts: 231
    misery HB User
    Re: Cauda Equina Symptoms with no clear etiology

    Woof, you are going thru some awful things and you def. have my prayers.All though I can't answer your questions I thought I'd post so that you know you aren't alone in all this.Many of us suffer greatly so it makes us one big( happy)family.
    The only thing I can think of that might help is that the docs can't always see everything on a mri.Have you had any surgery?Do the docs plan any?I know that the lower back is very painful as I suffer L4/5&s1 with pain in both legs and hips and in the mid back that know one will even look at.So hang in there and maybe some of guys will be able to shed some light for you.Also welcome to the boards.!!Misery

     
    Old 02-05-2005, 01:23 PM   #3
    Woofdog123
    Junior Member
     
    Join Date: Nov 2003
    Posts: 17
    Woofdog123 HB User
    Re: Cauda Equina Symptoms with no clear etiology

    Hi, thanks for your reply....as far as surgery, I could do something with the L4/5 disc, but hate to do a surgery with the primary goal being relief of CES-type symptoms and then to have the surgery have no effect. The fact recently acute sacral pain accompanied augmented loss of sacral nerve sensation without discogenic pain makes me more skeptical of taking that disc out/cooking it/cutting it, etc. A signifigant factor here is that while I do have LBP, it isn't SO bad that I want surgery just to address it alone at this point.

    As far as a sacral surgery to remove the protrusion, it is an idea but I am not clear on the mechanism whereby my movements (standing, sitting, etc) are able to impact what goes on in the interior of the bone as in theory it should have no effect, thus the bone scan to see if my sacrum has been fractured at some point.

     
    Old 02-05-2005, 01:34 PM   #4
    misery
    Senior Member
    (female)
     
    Join Date: Jan 2005
    Posts: 231
    misery HB User
    Re: Cauda Equina Symptoms with no clear etiology

    I'm in no way pushing surgery I've had 2 with no luckand I'm think they want to do another,(we'll see)I was just wondering.To me so much of what you have going on sounds like nerve damage.I know you said they didn't think that is what it is but it sure sounds that way.

     
    Old 02-05-2005, 05:38 PM   #5
    rob_zzz
    Senior Member
    (male)
     
    Join Date: Nov 2004
    Location: Sydney, Australia
    Posts: 123
    rob_zzz HB User
    Re: Cauda Equina Symptoms with no clear etiology

    I don't know anything about that end of the spine, but it sounds like there are a few candidates for causes there - I'm surprised that they are so dissmissive of a couple of them. I'm not a dr or anything but you'd think that when there's nerve conduction evidence plus stuff going on at s2 it would be worth a closer look. But it sounds like they've done a lot of tests and are having a pretty close look at it all. I hope they're not being too 'theoretical' in their diagnosis - not everyone's wired exactly the same. I guess until they're certain of the cause they wouldn't want to be doing surgery on it though. Thats a very tough situation for you - I hope you find someone that can help you sort it out.

     
    Old 02-06-2005, 10:51 AM   #6
    SuzU
    Senior Member
     
    Join Date: Mar 2003
    Location: Cranbury, NJ
    Posts: 219
    SuzU HB User
    Re: Cauda Equina Symptoms with no clear etiology

    I've had similar symptoms but my lumbar MRI was negative. (I didn't have contrast, though...)
    I'm being worked up for MS presently. I have cauda equina type symptoms but also arm, shoulder, facial, other symptoms as well.
    I can relate to having the pain in your lower back and the symptoms of tingling, numbness, bladder dysfunction, etc. I've had these intermittently and they always seem to worsen when I overdo lifting something heavy or ride on an exercise bicycle. Do you ride a bike? All of these symptoms could be associated with a saddle type injury.
    My cervical MRI shows a lesion-they are calling it a syrinx, which is small and most think insignificant. I also have arthritis, disc bulging, mild stenosis, like you, no-one finds these things diagnostically interesting.
    Consider getting a brain MRI to rule out MS. It can start with bladder/bowel symptoms. I know that doesn't sound like a nice dx, but there is treatment and it is better to start it early than late.
    Best wishes and prayers going your way.

     
    Old 02-09-2005, 08:58 PM   #7
    Woofdog123
    Junior Member
     
    Join Date: Nov 2003
    Posts: 17
    Woofdog123 HB User
    Re: Cauda Equina Symptoms with no clear etiology

    I have finally located the nerve damage area, though I do not understand what the mechanism of damage was nor what can be done from here.

    CT Myelogram with attention to sacrum finds following:

    "Saggital views over the sacrum demonstrate somewhat blunted thecal sac inferiorly at the S2 level. This has similar configuration to that seen on MRI. The areas (sic) an ectatic right-sided S2-3 level nerve root sheath just below this level which partially fills with contrast. This opacifies laterally with some soft tissue density medially. This could be rated to thickened nerve root......the someone (sic) dumbbell-shaped ecatsia just below the blunted thecal sac and thickened nerve root could be on the base of previous inflammation and scarring."

    It is not clear to me the mechanism of inflammation of the nerve roots, nor the remedies (if any) available to me. Anyone have experience with something like this?

     
    Old 02-10-2005, 02:56 AM   #8
    rob_zzz
    Senior Member
    (male)
     
    Join Date: Nov 2004
    Location: Sydney, Australia
    Posts: 123
    rob_zzz HB User
    Re: Cauda Equina Symptoms with no clear etiology

    wow - it must at least be a bit of relief for you that they've finally found some radiological evidence that fairly clearly ties in with the symptoms. (sorry - can't help with any answers for you though but hope you find some).

     
    Old 03-20-2005, 06:37 PM   #9
    aardvark555
    Newbie
    (male)
     
    Join Date: Mar 2005
    Posts: 4
    aardvark555 HB User
    Re: Cauda Equina Symptoms with no clear etiology

    Woofdog,

    I have what sounds like similar stuff going on for the past couple of years.
    I have been through SO many docs, urologists, neurologists, chiropractor, you name it... I do have a central protrusion at L5-S1. Also, I have a friend with the same exact symptoms. ED, back pain (sometimes), numbness is the genitals and perineum, inability to flex some muscles in that region, and other muscles flex sometimes. Seems to be worse in the morning and get better through the day unless I do something stupid. Makes numbness worse to sit slouched down or sit with my feet up on the desk. Lifting is bad, too.
    Anyway, I found this article that sounded just like me. My docs are more open to this being me. I have a surgery consult this week.
    Read this one. We could talk more if you want to bounce a few things back and forth and see if we are the same...

    http://www.wfneurology.org/docs/pdf/Munsat_chapter6.pdf

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    Cauda Equina Luedeenee Arachnoiditis 29 01-28-2008 09:38 PM
    Please, if you had Cauda Equina and Emergency Surgery then KonaKid Back Problems 12 04-11-2007 06:05 PM
    Question about cauda equina syndrome Jack24 Back Problems 15 04-10-2007 03:36 AM
    Cauda Equina Syndrome ? lfoster21 Back Problems 7 05-01-2006 06:01 PM
    ANYONE GOT OR HAD "cauda equina syndrome " WITHOUT COMPRESSION?? rachelmc Back Problems 0 03-23-2006 05:36 PM
    Is Cauda Equina Syndrome treatable? chocolate chip Back Problems 9 07-04-2005 06:25 AM
    Anyone else with Cauda Equina Syndrome Oklahoma_Angel Back Problems 0 08-27-2003 04:45 AM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 01:56 PM.





    2019 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!