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As neurologists become more involved with \u2018front door\u2019 neurology, referral rates of patients with these symptoms are increasing. A small proportion of patients without structural pathology have other neurological causes: we discuss the differential diagnosis and how to recognise these. New data on the clinical features of patients with \u2018scan-negative\u2019 cauda equina syndrome suggest that the symptoms are usually triggered by acute pain (with or without root impingement) causing changes in brain\u2013bladder feedback in vulnerable individuals, exacerbated by medication and anxiety, and commonly presenting with features of functional neurological disorder.<\/jats:p>","DOI":"10.1136\/practneurol-2020-002830","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T13:25:47Z","timestamp":1628861147000},"page":"6-13","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["\u2018Scan-negative\u2019 cauda equina syndrome: what to do when there is no neurosurgical cause"],"prefix":"10.1136","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6742-7197","authenticated-orcid":false,"given":"Ingrid","family":"Hoeritzauer","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK"},{"name":"Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biba","family":"Stanton","sequence":"additional","affiliation":[{"name":"Department of Neurology, King\u2019s College Hospital, Neuropsychiatry Service, South London & Maudsley NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Carson","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK"},{"name":"Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9829-8092","authenticated-orcid":false,"given":"Jon","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK"},{"name":"Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,13]]},"reference":[{"key":"2025090410021519000_22.1.6.1","first-page":"1","article-title":"What is the incidence of cauda equina syndrome? 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