definition

With breeches anesthesia, the sensitivity is in the range of Genital and anus regions, as well as the Inner thigh reduced or canceled. Since the distribution pattern described resembles riding breeches or corresponds to their padded area, one speaks in this context of a "Breeches anesthesia“.
One is responsible Damage to the spinal cord nerves in the sacrum region (S3-S5). Since the spinal nerves are responsible for both our sensitive sensations (Touch, temperature sensation, pain etc.) as well as Motor skills (Move) are responsible, a violation of these structures can result in extensive restrictions, including the breeches anesthesia.

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Causes of breeches anesthesia

Can cause acute breeches anesthesia Herniated discs, Tumors, Metastases, Bleeding or a trauma be. All mechanisms lead to an injury or compression of the spinal cord nerves, also called spinal nerves.
Large herniated discs below the 2nd lumbar vertebra damage e.g. the lower part of the spinal nerve plexus (Cauda equina) and can have a "Cauda Syndrome“Trigger with breeches anesthesia. Also at "Konus Syndrome“, Damage to the structure of the same name at the level of the first lumbar vertebrae, can cause the reduced sensitivity in the area of ​​the saddlebags.

Read more about the Recognizing a herniated disc.

Herniated disc of the lumbar spine

The cause of breeches anesthesia is damage to the nerve roots in the area of ​​the sacral nerve fibers (S3-S5), which represent the end of the spinal cord. In rare cases, a herniated disc in the lumbar spine can compress these nerve roots, especially if the herniated disc occurs in the lower-lying segments of the lumbar spine (e.g. L5 / S1). This is usually an emergency situation, as there is a high risk of developing cauda equina syndrome.

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Read more on the topic: Disc prolapse

Symptoms of breeches anesthesia

This is a typical symptom of breeches anesthesia decreased sentience in the field of Inner thigh, as well as the Anus and genital region. Affected people complain about Numbness, tingle, Burn, or "Ant running". The pronounced, local delimitation in the area of ​​the breeches is characteristic.
Additionally can Urination- and Rectal disorders be observed: Occurring suddenly Incontinence, lack of urge to urinate or problems urinating are an indication of the disorders described.

Furthermore, in addition to sensitive failure symptoms can also motor restrictions occur. First and foremost here is the Leg muscles affected. Mild weakness can e.g. express it by kinking or stumbling frequently. In severe cases, however, those affected suffer from complete paralysis (Paresis) of the legs. Men also report impotence.

Diagnosis of breeches anesthesia

In order to be able to make the diagnosis of breeches anesthesia clear, the questioning and physical examination is the "A and O."The most important information is the typical sensitive deficits in the genital and anus region, as well as the inner thigh. If there are other symptoms, such as problems with urination or paralysis of the legs, the suspicion of breeches anesthesia is close.
Your treating doctor can also Strength checks of the legs carry out. Lack of reflexes of the legs (such as. Loss of the Achilles tendon reflex) can also speak for breeches anesthesia.

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A picture of the back or the spine provides final clarity. First choice is this Magnetic resonance imaging (MRI) of the spine. In this painless examination, patients without radiation exposure are placed in a "tubeAfter a short time, high-resolution images are created, on which, for example, possible herniated discs or tumors can be easily identified.
If there is no MRI machine available or if there is a great urgency, the Computed Tomography (CT) represent a sensible, very quick alternative. However, the disadvantage of this examination is the relatively high radiation exposure.

Under certain circumstances, a Blood test be helpful, e.g. Inflammation can be made visible.

Therapy of breeches anesthesia

Suddenly occurring breeches anesthesia are always a problem absolute emergency not treated threatens a deep Paraplegia with irreparable long-term consequences.
In order to relieve dangerous spinal cord nerves as quickly as possible or to "save“, Those affected should therefore very quickly operated on become. Depending on the extent of the injury, surgical treatment can be used minimally invasive ("Keyhole principle") or with larger access routes fail. E.g. in the case of a herniated disc, the damaged or "slipped“Disc removed so that it can no longer press on the delicate spinal cords. In the vast majority of cases, the therapy takes place in general anestheticso that patients do not feel anything during the operation.

What is the difference to cauda equina syndrome?

Riding breeches anesthesia is a sensory disorder or a feeling of numbness in the area of ​​the genitals, the region around the buttocks and the inner thighs.

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In the case of cauda equina syndrome, there is usually riding breeches anesthesia; For example, there is severe back pain that radiates into the legs (radicular symptoms). In addition, there are motor disorders of the muscles in the legs (for example, weakness in the dorsiflexion of the foot). The autonomic nervous system is also affected, and patients complain of urinary and faecal incontinence and impotence.


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