PDF(Pubmed)
Abstract：
The cauda equina syndrome (CES) is a rare but critical disorder, which can result in devastating motor weakness and sensory deficit, alongside often irreversible bladder, bowel and sexual dysfunction. In addition to the clinical burden of disease, this syndrome results in a disproportionately high medicolegal strain due to missed or delayed diagnoses. Despite being an emergency diagnosis, often necessitating urgent surgical decompression to treat, we believe there is a lack of clarity for clinicians in the current literature, with no published Irish guideline concerning screening or detection. The current study aims to identify and analyse appropriate guidelines in relation to CES screening which are available to clinicians in Ireland. The study design included a comprehensive literature review and comparison of existing guidelines. The review identified 13 sources of appropriate guidance for clinicians working in Ireland. These resources included textbooks, websites and guidelines developed in the UK. No Irish guidelines or advice were available on CES screening/treatment at the time of review. This review demonstrated the lack of consensus and guidance for clinicians in Ireland on how to effectively screen for CES, judge who requires further imaging and investigations and how to rule out the condition. A national consensus on thorough screening and prompt investigation for CES is necessary, and the formulation of new CES guidelines would be a welcome addition to what is available to clinicians currently.
摘要：
马尾综合症（CES）是一种罕见但严重的疾病，这会导致毁灭性的运动无力和感觉缺陷，除了经常不可逆的膀胱，肠道和性功能障碍。除了疾病的临床负担，由于漏诊或延误诊断,该综合征导致不成比例的高法医学毒株.尽管是紧急诊断，通常需要紧急手术减压治疗，我们认为目前的文献中临床医生缺乏清晰度，没有公布的关于筛查或检测的爱尔兰指南。本研究旨在确定和分析爱尔兰临床医生可获得的与CES筛查相关的适当指南。研究设计包括全面的文献回顾和现有指南的比较。该审查为在爱尔兰工作的临床医生确定了13个适当的指导来源。这些资源包括教科书，在英国开发的网站和指南。在审查时，没有关于CES筛查/治疗的爱尔兰指南或建议。这项审查表明，爱尔兰的临床医生在如何有效筛选CES方面缺乏共识和指导，判断谁需要进一步的成像和调查，以及如何排除这种情况。有必要就CES的彻底筛查和迅速调查达成全国共识，新的CES指南的制定将是目前临床医生可获得的一个受欢迎的补充。
