Order cauda equina syndrome assessment
A 70-year-old man who is independently mobile and lives with his son presents with a sudden fall accompanied by a
burning back pain. Past history includes
diet-controlled diabetes, hypertension
and atrial fibrillation. In the previous
days, he had been suffering from a lower
respiratory tract infection for which his
GP had commenced a five-day course of
amoxicillin. The patient was on the last
day of his treatment and was recovering
from his symptoms when his legs gave
way beneath him as he stood up. He was
unable to get up thereafter and his son
called for an ambulance. On examination,
his lower limbs are areflexic with bilateral extensor plantars. A sensory level is
detected at the umbilicus. Proprioception
and vibration sense are intact. Power
is 2/5 in the lower limbs and 5/5 in the
upper limbs. Which of the following is
the most likely diagnosis in this case?
A. cauda equina syndrome
B. side effect of amoxicillin
C. spinal cord compression
D. spinal cord infarction
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