The Journal of the Association of Physicians of India · 2019
Etiological Spectrum of Non-compressive Myelopathies in Tertiary Care Centre.
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Kamble Sumit, Sardana Vijay, Maheshwari Dilip, Bhushan Bharat, Ojha Piyush
Аннотация
AIMS: To study the clinical, radiological, cerebrospinal fluid profile of noncompressive myelopathy and to study various etiologies of non-compressive myelopathies in causation of quadriplegia and paraplegia.
STUDY DESIGN: Observational study.
PLACE AND DURATION OF STUDY: Department of Neurology, Govt. Medical College, Kota in year 2015 and 2016.
METHODOLOGY: All the patients presented with myelopathy and MRI spine not showing any significant compression included in study. To know the etiology of non-compressive myelopathy patients were investigated including routine blood tests, cerebrospinal fluid analysis and visual evoked potentials, MRI of the brain, and immunological, infectious, and metabolic profile based on the pattern of involvement.
RESULTS: The study had 80 patients with a median age of 38 years and male: female ratio 1.5:1. Patients were divided into acute myelopathy and chronic myelopathy. Forty four patients presented with acute myelopathy whereas 36 patients had chronic myelopathy. The causes of Acute myelopathy were post infectious myelitis (13), neuromyelitis optica spectrum disorder (NMOSD) (6), multiple sclerosis (MS) (2), connective tissue disorders (1), acute disseminated encephalomyelitis (4) and Idiopathic (18). The causes of Chronic myelopathy were Vitamin B12 deficiency (8), MS (2), mixed connective tissue disease (1), Copper deficiency (1), hepatic myelopathy (1), radiation (1), hereditary spastic paraparesis (1) and idiopathic (21).
CONCLUSION: Underlying etiology like demyelinating, infectious/post infectious, autoimmune or nutritional was found in 52% patients of non-compressive myelopathy.
STUDY DESIGN: Observational study.
PLACE AND DURATION OF STUDY: Department of Neurology, Govt. Medical College, Kota in year 2015 and 2016.
METHODOLOGY: All the patients presented with myelopathy and MRI spine not showing any significant compression included in study. To know the etiology of non-compressive myelopathy patients were investigated including routine blood tests, cerebrospinal fluid analysis and visual evoked potentials, MRI of the brain, and immunological, infectious, and metabolic profile based on the pattern of involvement.
RESULTS: The study had 80 patients with a median age of 38 years and male: female ratio 1.5:1. Patients were divided into acute myelopathy and chronic myelopathy. Forty four patients presented with acute myelopathy whereas 36 patients had chronic myelopathy. The causes of Acute myelopathy were post infectious myelitis (13), neuromyelitis optica spectrum disorder (NMOSD) (6), multiple sclerosis (MS) (2), connective tissue disorders (1), acute disseminated encephalomyelitis (4) and Idiopathic (18). The causes of Chronic myelopathy were Vitamin B12 deficiency (8), MS (2), mixed connective tissue disease (1), Copper deficiency (1), hepatic myelopathy (1), radiation (1), hereditary spastic paraparesis (1) and idiopathic (21).
CONCLUSION: Underlying etiology like demyelinating, infectious/post infectious, autoimmune or nutritional was found in 52% patients of non-compressive myelopathy.