Suspected cauda equina syndrome is a common presentation in emergency departments, but most patients (≥70%) have no cauda equina compression on imaging. As neurologists become more involved with ‘front door’ 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 ‘scan-negative’ cauda equina syndrome suggest that the symptoms are usually triggered by acute pain (with or without root impingement) causing changes in brain–bladder feedback in vulnerable individuals, exacerbated by medication and anxiety, and commonly presenting with features of functional neurological disorder.

中文翻译：

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“扫描阴性”马尾综合征：没有神经外科原因时该怎么办

疑似马尾神经综合征是急诊科的常见表现，但大多数患者（≥70%）在影像学上没有马尾神经受压。随着神经科医生越来越多地参与“前门”神经病学，出现这些症状的患者的转诊率正在增加。一小部分没有结构病理学的患者有其他神经系统原因：我们讨论鉴别诊断以及如何识别这些原因。关于“扫描阴性”马尾神经综合征患者临床特征的新数据表明，症状通常由急性疼痛（伴有或不伴有根部撞击）引发，导致易感个体的脑-膀胱反馈发生变化，药物和焦虑加剧，并且通常表现为功能性神经障碍的特征。