Neurológia pre prax 6/2013

Cauda equina syndrome during pregnancy

Cauda equina syndrome is relatively rare condition and may require urgent neurosurgical intervention. When fully developed, it‘s characterized by bilateral sciatica, saddle hypaesthesia, motor weakness of lower extremities and impairment of sphincters’ functions. The most frequent cause is compression of spinal nerve roots by large lumbar disc herniation below the level of conus medullaris. In common clinical practice a lumbar disc herniation in a pregnant woman is a sparse condition and cauda equina syndrome is then rarity. The case of surgically treated cauda equina syndrome due to large lumbar disc herniation L5/S1 in 35-year-old woman at 22 weeks’ of pregnancy is presented. The objective of this report is to draw attention to this rare clinical condition and discuss distinctions in diagnostics, anaesthesia and surgical treatment in pregnancy. Finally the importance of time factor for favourable treatment outcome is discussed.

Keywords: lumbar disc herniation, cauda equina syndrome, pregnancy.