A 40-year-old male presents with acute urinary retention, bilateral leg weakness, and saddle anaesthesia following a lifting injury at work. He has re...

Question

A 40-year-old male presents with acute urinary retention, bilateral leg weakness, and saddle anaesthesia following a lifting injury at work. He has reduced anal tone on examination. What is the diagnosis and what is the time-critical threshold for treatment?

Accepted Answer

Cauda equina syndrome - surgical decompression should ideally occur within 48 hours but is most effective within 24 hours

Answer

Lumbar disc prolapse without red flags - GP review within 2 weeks

Answer

Guillain-Barré syndrome - IV immunoglobulin within 5 days

Answer

Spinal cord infarction - thrombolysis within 4.5 hours

Answer

Conus medullaris syndrome - requires MRI within 1 week

uk-dipimc MCQ (SBA): Cauda Equina Syndrome

A 40-year-old male presents with acute urinary retention, bilateral leg weakness, and saddle anaesthesia following a lifting injury at work. He has reduced anal tone on examination. What is the diagnosis and what is the time-critical threshold for treatment?