Which symptom is a red flag suggesting cauda equina syndrome?

Which symptom is a red flag suggesting cauda equina syndrome?

• A. Saddle anesthesia
• B. Mild neck stiffness
• C. Occipital headache
• D. Low back dull ache

Answer: (A)

Saddle anesthesia signals cauda equina compression because it reflects loss of sensation in the perineal region supplied by the sacral nerve roots (S2–S4). This pattern of sensory loss is a classic red flag for cauda equina syndrome and requires urgent imaging and specialist evaluation to prevent permanent deficits. The other symptoms don’t point to cauda equina: mild neck stiffness and an occipital headache suggest cranial or meningeal issues, not nerve root compression in the lower spine, and a nonspecific low back dull ache is not diagnostic of CES.

Saddle anesthesia signals cauda equina compression because it reflects loss of sensation in the perineal region supplied by the sacral nerve roots (S2–S4). This pattern of sensory loss is a classic red flag for cauda equina syndrome and requires urgent imaging and specialist evaluation to prevent permanent deficits. The other symptoms don’t point to cauda equina: mild neck stiffness and an occipital headache suggest cranial or meningeal issues, not nerve root compression in the lower spine, and a nonspecific low back dull ache is not diagnostic of CES.