Annals of Neurology and Neuroscience | Volume 1, Issue 1 | Research Article | Open Access
Qasim Zia*
Qasim Zia1*, Muhammad Usama Khalid1, Zunair Nasir1, Rafia Ejaz2, Muhammad Hamza Khan3, Muhammad Sheraz3, Hajra Azmat4, Fatima Faheem Khan5, Abeera Masood Hunjra5, Muhammad Abdullah Tariq6
1Multan Medical & Dental College, Multan
2Bakhtawar Amin Medical and Dental College, Multan
3Nishtar Medical University, Multan
4M. Islam Medical and Dental College, Gujranwala
5Bahawal Victoria Hospital, Bahawalpur
6Benazir Bhutto Hospital, Rawalpindi
Fulltext PDFCauda Equina Syndrome (CES) is a rare but devastating neurological emergency characterized by compression of the lumbosacral nerve roots, most commonly resulting from lumbar disc herniation. Prompt diagnosis and urgent surgical decompression are essential to prevent irreversible neurological deficits, including paralysis, bladder dysfunction, and sexual impairment. Despite the clinical urgency, diagnostic delays in emergency departments (EDs) remain a persistent and well-documented problem worldwide.
This retrospective observational study aimed to evaluate the prevalence, causes, and consequences of diagnostic delays in CES among patients presenting to the ED. Data were collected from patients with MRI-confirmed CES over a four-year period. Variables analyzed included symptom presentation, clinical documentation, time to diagnosis, imaging delays, referral pathways, and neurological outcomes.
The findings indicate that diagnostic delays occurred in more than half of the cases and were associated with atypical clinical presentations, inadequate recognition of red flag symptoms, and systemic factors such as delays in imaging availability. These delays were significantly associated with poorer neurological outcomes, particularly persistent bladder dysfunction.
The study highlights the need for improved clinical awareness, standardized diagnostic protocols, and expedited access to imaging to reduce delays. Addressing these challenges is critical not only for improving patient outcomes but also for reducing the substantial medico-legal burden associated with CES.
Qasim Zia, Muhammad Usama Khalid, Zunair Nasir, Rafia Ejaz, Muhammad Hamza Khan, Muhammad Sheraz, et al. Diagnostic Delays in Cauda Equina Syndrome: A Retrospective Emergency Department Study. Anna Neur & Neurosci. 2026;1(1):1-6.