Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India
Background: The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21st century have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic. Objective: To find causes of noncompressive myelopa...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Annals of Indian Academy of Neurology |
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| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=1;spage=41;epage=50;aulast=Kayal |
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| author | Ashok Kumar Kayal Munindra Goswami Marami Das Lakhshya Jyoti Basumatary Suvorit Subhas Bhowmick Baiakmenlang Synmon |
| author_facet | Ashok Kumar Kayal Munindra Goswami Marami Das Lakhshya Jyoti Basumatary Suvorit Subhas Bhowmick Baiakmenlang Synmon |
| author_sort | Ashok Kumar Kayal |
| collection | DOAJ |
| description | Background: The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21st century have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic. Objective: To find causes of noncompressive myelopathy in a tertiary care hospital of Northeast India. Materials and Methods: An observational study was carried out in the Neurology Department of Gauhati Medical College, Guwahati, from September 2013 to February 2016. Patients of noncompressive myelopathies who underwent magnetic resonance imaging (MRI) of the spine were segregated into two categories: acute-to-subacute myelopathy (ASM) and chronic myelopathy (CM). In addition to routine blood tests, chest X-ray, urinalysis, and visual evoked potentials, investigations included MRI of the brain, cerebrospinal fluid analysis, and immunological, infectious, and metabolic profile based on the pattern of involvement. Results: The study had 151 patients (96 ASM and 55 CM) with a median age of 35 years and male: female ratio 1.4:1. The causes of ASM were neuromyelitis optica spectrum disorder (23), multiple sclerosis (MS) (8), systemic lupus erythematosus (1), Hashimoto's disease (1), postinfectious acute disseminated encephalomyelitis (6), postinfectious myelitis (8), infections (9), spinal cord infarct (5), and electrocution (1). The causes of CM were MS (1), probable or possible sarcoidosis (7), mixed connective tissue disease (1), Hashimoto's disease (2), infections (9), Vitamin B12deficiency (4), folate deficiency (2), hepatic myelopathy (2), radiation (11), and paraneoplastic (1). No etiology could be found in 48 (31.8% ) patients (34 ASM and 14 CM). In 21/96 (21.9% ) patients of ASM, acute transverse myelitis was idiopathic based on current diagnostic criteria. Conclusion: Underlying etiology (demyelinating, autoimmune, infectious, vascular, metabolic disorder, or physical agent) was found in 68% patients of noncompressive myelopathy. |
| first_indexed | 2024-12-10T04:40:36Z |
| format | Article |
| id | doaj.art-287e3a3f206a47baacd92846a06846f8 |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-12-10T04:40:36Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-287e3a3f206a47baacd92846a06846f82022-12-22T02:01:53ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492017-01-01201415010.4103/0972-2327.199904Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast IndiaAshok Kumar KayalMunindra GoswamiMarami DasLakhshya Jyoti BasumatarySuvorit Subhas BhowmickBaiakmenlang SynmonBackground: The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21st century have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic. Objective: To find causes of noncompressive myelopathy in a tertiary care hospital of Northeast India. Materials and Methods: An observational study was carried out in the Neurology Department of Gauhati Medical College, Guwahati, from September 2013 to February 2016. Patients of noncompressive myelopathies who underwent magnetic resonance imaging (MRI) of the spine were segregated into two categories: acute-to-subacute myelopathy (ASM) and chronic myelopathy (CM). In addition to routine blood tests, chest X-ray, urinalysis, and visual evoked potentials, investigations included MRI of the brain, cerebrospinal fluid analysis, and immunological, infectious, and metabolic profile based on the pattern of involvement. Results: The study had 151 patients (96 ASM and 55 CM) with a median age of 35 years and male: female ratio 1.4:1. The causes of ASM were neuromyelitis optica spectrum disorder (23), multiple sclerosis (MS) (8), systemic lupus erythematosus (1), Hashimoto's disease (1), postinfectious acute disseminated encephalomyelitis (6), postinfectious myelitis (8), infections (9), spinal cord infarct (5), and electrocution (1). The causes of CM were MS (1), probable or possible sarcoidosis (7), mixed connective tissue disease (1), Hashimoto's disease (2), infections (9), Vitamin B12deficiency (4), folate deficiency (2), hepatic myelopathy (2), radiation (11), and paraneoplastic (1). No etiology could be found in 48 (31.8% ) patients (34 ASM and 14 CM). In 21/96 (21.9% ) patients of ASM, acute transverse myelitis was idiopathic based on current diagnostic criteria. Conclusion: Underlying etiology (demyelinating, autoimmune, infectious, vascular, metabolic disorder, or physical agent) was found in 68% patients of noncompressive myelopathy.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=1;spage=41;epage=50;aulast=KayalNeuromyelitis opticanoncompressive myelopathiestransverse myelitis |
| spellingShingle | Ashok Kumar Kayal Munindra Goswami Marami Das Lakhshya Jyoti Basumatary Suvorit Subhas Bhowmick Baiakmenlang Synmon Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India Annals of Indian Academy of Neurology Neuromyelitis optica noncompressive myelopathies transverse myelitis |
| title | Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India |
| title_full | Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India |
| title_fullStr | Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India |
| title_full_unstemmed | Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India |
| title_short | Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India |
| title_sort | etiological profile of noncompressive myelopathies in a tertiary care hospital of northeast india |
| topic | Neuromyelitis optica noncompressive myelopathies transverse myelitis |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=1;spage=41;epage=50;aulast=Kayal |
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