Definition
With a breeches anaesthesia, sensitivity in the genital and anal region as well as the inner side of the thigh is reduced or eliminated. Since the described distribution pattern is similar to that of a pair of riding breeches or corresponds to their padded area, this is referred to as “breeches anaesthesia” in this context. Responsible for this is damage to the spinal nerves in the sacral region (S3-S5). Since the spinal nerves are responsible for both our sensitive sensations (touch, temperature sensation, pain, etc.) and motor functions (movement), injury to these structures can result in extensive restrictions, including breeches anaesthesia.
Causes of a breeches anaesthesia
Causes for acutely occurring breeches anaesthesia can be herniated discs, tumours, metastases, bleeding or trauma. All mechanisms lead to an injury or compression of the spinal 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 thus trigger a “cauda syndrome” with breeches anaesthesia.
In the “cone syndrome”, a damage to the structure of the same name at the level of the first lumbar vertebral body, the reduced sensitivity in the area of the riding breeches can also be caused. The cause of riding 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 of a herniated disc in the lumbar spine, these nerve roots may be compressed, especially if the herniated disc occurs in the deeper segments of the lumbar spine (for example L5/S1). This is usually an emergency situation, as there is a high risk of developing a cauda syndrome.
Symptoms of anesthesia of riding breeches
A typical symptom of the anaesthesia of the riding breeches is the reduced sensitivity in the area of the inner thigh, as well as the anus and genital region. Affected persons complain of numbness, tingling, burning, or “formication”. Characteristic is the pronounced, localized limitation in the area of the breeches.
In addition, bladder voiding and rectal disorders can be observed: Sudden incontinence, lack of urge to urinate or problems with urination are indications of the described disorders. Furthermore, besides sensitive failure symptoms, also motor limitations can occur. Primarily the leg muscles are affected.
Slight weakness can manifest itself e.g. by frequent bending or stumbling. In severe cases, however, those affected suffer from complete paralysis (paresis) of the legs. Men also report impotence.
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