emDocs - January 29, 2014 - By Jennifer Robertoson
"Bottom Line/Pearls & Pitfalls
The bottom line is to keep a high level of suspicion and do a full sensory and rectal exam on any patient who may present with concerning symptoms of CES. The diagnosis cannot be confirmed by history and examination alone, so consider imaging strongly. Continue to refer all patients early as the proper timing of surgery and long-term outcomes has not yet been determined. Always document thoroughly and keep patients informed. If a patient with sciatica has no concerning signs of CES on history and exam, make sure to provide strict return precautions and tell him or her to return immediately if there are symptoms of CES such as incontinence, saddle anesthesia, and/or lower limb weakness."
http://www.emdocs.net/cauda-equina-syndrome/