25.1.22
Spinal Cord Compression (late Presentation)
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 25, Palliative Care.
Clinical Description
Metastatic cancer (breast, prostate, renal etc.), presents with neurological deficit (weakness, paresthesia, incontinence of stool and urine). Refer to neurosurgery for imaging and possible intervention (surgical/radiotherapy) only if patient presents early (within 24 hours of neurological symptom onset). Common causes (see relevant chapter for details)
Non-pharmacological
see under constipation, urinary symptoms, bed sores.
Pharmacological
- if seen early, trial of high dose dexamethasone may temporarily reverse some of the neurological sequelae. Dexamethasone 16-20mg IV or PO STAT. Review after 24 hours. if improved then continue Dexamethasone 8mg 12 hourly for one week, if no change then no need to continue.
Complications and Referral Criteria
- Depending on the level of care, refer for appropriate care.
Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.
Need this without data?
The app holds every guideline on your device, with calculators, bookmarks and notes.