Title: Etiological Spectrum of Non-Traumatic Myelopathies in Adults Using MRI at a Tertiary Care Hospital in Jharkhand

Authors: Dr Pughaz Deivigan, Dr Rajeev Kumar Ranjan, Dr Suresh Kumar Toppo, Dr Roopam Kumari, Dr Vijay Kumar

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.137

Abstract

Aims & Objectives: 1] To estimate the prevalence of Non-traumatic Myelopathy. 2] To estimate the percentages of various causes of non traumatic myelopathies. 3] To compare the various causes between different age groups, males and females.

Materials & Methods: 50 Patients with a clinical diagnosis of non-traumatic Myelopathy referred to the Department of Radiology, RIMS, Ranchi during the study period from August 2017 to October 2018 were studied after obtaining consent. Age and sex of the patient were noted. Detailed history and neurological examination was obtained from all the patients. MRI of spine of all patients and MRI of brain of selected patients were carried out. Based on MRI findings alone causes of non-traumatic Myelopathies were categorized.

Results: Among 50 cases of Non-Traumatic Myelopathies, 29 cases (58%) were presented with Paraparesis and 21 cases (42%) were presented with Quadriparasesis. 27(54%) cases were grouped into cord compressive and 20 (40%) were grouped into Non compressive group, while in 3(6%) case no etiology could be found on MRI. Tuberculosis was the major cause in compressive group while Acute Transverse Myelitis was the major cause in Non compressive group.

Conclusion: Quadriplegia and paraplegia are conditions with considerable morbidity and regarded as a disease of constant misery to the patient, family and the society. It is difficult to conclude the diagnosis in spinal cord pathologies on clinical basis alone where imaging particularly MRI plays a major role in diagnosing and classifying the various causes of Non traumatic Myelopathies.

Keywords: Non-traumatic Myelopathies, MRI, Paraparesis, Quadriparasesis.

References

  1. Kelley BJ, Erickson BJ, Weinshenker BG. Compressive myelopathy mimicking transverse myelitis. Neurologist. 2010;
  2. Jankowitz BT, Gerszten PC. Decompression for cervical myelopathy. Spine Journal. 2006.
  3. Schmalstieg WF, Weinshenker BG. Approach to acute or subacute myelopathy. Neurology. 2010;
  4. Chaurasia RN, Verma A, Joshi D, Misra S. Etiological spectrum of non-traumatic myelopathies: Experience from a tertiary care centre. J Assoc Physicians India. 2006;
  5. Joshi BR. Role of MRI in Non-Traumatic Paraparesis and Tetraparesis. 2015;2(7):2–4.
  6. Yadav RK, Agarwal S, Saini J. Profile of compressive myelopathy as evaluated by magnetic resonance imaging. J Indian Med Assoc. 2008;
  7. Moore AP, Blumhardt LD. A prospective survey of the causes of non-traumatic spastic paraparesis and tetraparesis in 585 patients. Spinal Cord. 1997;
  8. Looti AZL, Kengne AP, Djientcheu VDP, Kuate CT, Njamnshi AK. Patterns of non-traumatic myelopathies in Yaoundé (Cameroon): A hospital based study. J Neurol Neurosurg Psychiatry. 2010;
  9. Mehrotra AN, Khosla SN, Pathak LR, Singh B. Spinal paraplegias. J Assoc Physicians India [Internet]. 1966 Feb [cited 2018 Nov 27];14(2):121–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/5905980
  10. Prabhakar S, Syal P, Singh P, Lal V, Khandelwal N, Das CP. Non-compressive myelopathy: clinical and radiological study. Neurol India. 1999;
  11. Dawson DM, Potts F. Acute nontraumatic myelopathies. Neurol Clin [Internet]. 1991 Aug [cited 2018 Nov 27];9(3):585–603. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1921948
  12. Bakshi, Kinkel, Mechtler, Bates, Lindsay, Esposito, et al. Magnetic resonance imaging findings in 22 cases of myelitis: comparison between patients with and without multiple sclerosis. Eur J Neurol [Internet]. 1998 Jan [cited 2018 Nov 27];5(1):35–48. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10210810
  13. Austin SG, Zee CS, Waters C. The role of magnetic resonance imaging in acute transverse myelitis. Can J Neurol Sci [Internet]. 1992 Nov [cited 2018 Nov 27];19(4):508–11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1423048
  14. Jacobi C, Stingele K, Kretz R, Hartmann M, Storch-Hagenlocher B, Breitbart A, et al. Neuromyelitis optica (Devic’s syndr-ome) as first manifestation of systemic lupus erythematosus. Lupus. 2006;
  15. Turner MR, Talbot K. Functional vitamin B12 deficiency. Pract Neurol. 2009;

Corresponding Author

Dr Pughaz Deivigan

Add: Hostel 5, Rims Boy’s hostel, RIMS, Bariyatu, Ranchi 834009, India

Mobile No: 9940963370, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.