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Doctoral Thesis | Neurology | India | Volume 12 Issue 12, December 2023 | Popularity: 5.2 / 10
Clinical Spectrum and Functional Outcome of Patients with Non-Compressive Myelopathy
Vishwanath Yanamandra, Munindra Goswami, Marami Das
Abstract: Background: The discovery of antibodies against aquaporin-4 and evolving concepts of non-compressive myelopathies in the 21st century have made a major impact on the etiological profile of these diseases. Objective: To evaluate the clinical manifestations and etiological profile of patients with non-compressive myelopathy and study the functional status of patients with non-compressive myelopathy at presentation and after 3 months in a tertiary care hospital of Northeast India. Materials and methods: A Prospective observational study was carried out in the patients admitted to the Neurology ward and allied departments of Gauhati Medical college and hospital, Guwahati from November 2021 to February 2023. Patients of non-compressive myelopathy were included in the study. In addition to routine blood tests, chest X-ray, urinalysis, and visual evoked potentials, investigations included MRI of the brain and spinal cord, cerebrospinal fluid analysis, and immunological, infectious, and metabolic profile based on the pattern of involvement were done in this study. Results: Etiological diagnosis could be established in 78% of the cases, 20% of our cases were diagnosed to have idiopathic LETM, NMO was diagnosed in 28% cases, ATM in 26% cases, sAVM in 2% cases, hereditary spastic paraplegia (HSP) in 14% cases, Herpes Myelitis in 2% cases, Cryptococcal Myelitis in 2% cases, imaging negative myelitis (INM) in 2% cases and MS in 4% cases. On follow up based on mRS and Barthel index a total of 76% cases improved, 18% cases were static, 2% cases expired and 4% cases have been lost to follow up. There was a statistically significant difference in the Barthel Index and mRS scores between the groups who have and do not have bladder disturbance and quadriparesis at presentation and at 3 months follow-up as well. Conclusion: The commonest cause of non-compressive myelopathy was found to be NMOSD, followed by idiopathic LETM and acute transverse myelitis. Significant number of patients improved in their functional status at the end of 3 months.
Keywords: Neuromyelitisoptica, noncompressive myelopathies, transverse myelitis
Edition: Volume 12 Issue 12, December 2023
Pages: 1763 - 1767
DOI: https://www.doi.org/10.21275/MR231127062126
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