A Study on the Clinical, Radiological and Etiological Profile of Non-Traumatic Myelopathies in South Tamilnadu

BACKGROUND: Quadriplegia and paraplegia resulting from non-traumatic myelopathy is a disabling and distressing neurological disease. The clinical presentation of spinal cord disease is varied. Myelopathies not only affects the motor, sensory and autonomic functions but also has serious psychosocial sequelae. The present study aimed to study the clinical, radiological and etiological profile of non traumatic myelopathies. METHODS: Fifty patients admitted to medicine and neurology wards with myelopathies were studied, in which those with history of trauma were excluded. Study included a standardized proforma and detailed neurological examination. Patients were clinically evaluated and relevant routine biochemical analysis and appropriate neuroimaging studies were carried in all patients. Patients were categorized according to the onset of illness, clinical picture as complete and incomplete myelopathy, compressive or noncompressive.MRI was done in all cases. All cases with no obvious compression visible on MRI underwent further relevant investigations.CSF examination was done to rule out secondary causes. Visually Evoked Potential was done in relevant cases of transverse myelitis. An oral consent was taken from all patients for a detailed clinical history and examination and the required laboratory investigations. The details collected from each patient were entered in the proforma. RESULTS: Both males and females were equally affected.64% of the patients presented with Quadriparesis, rest with paraparesis.26 patients presented with subacute onset of weakness, followed by 13 (26%) with insidious onset followed by 22% with acute onset.18 patients presented with clinical picture of complete myelopathy, 32 had incomplete myelopathy. Of those with incomplete myelopathy, 28 patients had a compressive cause for the myelopathy and extradural compression accounted for most of them (85%). MRI was done in all patients, was negative in 8 patients with complete myelopathy and showed lesion in all most all patients with incomplete myelopathy. The most common cause of myelopathy was tumors. Its incidence in our study is 20% followed by pott’s spine and Acute Transverse myelitis. Other causes were disc prolapse, Craniovertebral junction anomalies, Syringomyelia, Acute disseminated encephalomyelitis. CONCLUSION: In our study, it was found, Tumors and Potts spine were the most common cause of compressive myelopathy. Acute Transverse myelitis was the most common cause of noncompressive myelopathy. Clinical Profile of Non Traumatic myelopathy in South Tamil Nadu is similar to that of reported in other parts of India, with Transverse Myelitis, Tumors, and Spinal Tuberculosis accounting over half the causes