The Clinical Pattern and Etiology of Non Traumatic paraplegia

Abstract

Worldwide paraplegia is a major disabling health problem . Its importance is due to the incapacitating disability that often persist despite treatment . It encompasses a large range of disease entities ranging from demyelination, infection, nutritional, toxic, heredo-familial to degenerative conditions. This disease has particularly invoked great interest among neurologists as it strikes apparently healthy individuals in the prime of their lives, who are left with variable degree of sequelae . The study tried to identify the various etiologies , the ways of presentation and helpful diagnostic tools to each . The study took place in El Shaab teaching hospital in the year 2002- 2003 . Patients included in the study are those who present to the hospital or referred to the neurologist , with LL weakness. 100 patients were included in the study . 56% of whom are males and 44% are females , and originally from different states of the country and different racial groups . Complete paralysis was detected in 56% of the study patients, 22% are in need of support and 22% do well independently . Guillian Barre (19%) , Transverse myelitis (15%) , Potts disease of the spine (12%) , primary (3%) and secondary (13%) tumors constituted the etiological bulk of paraplegia in the study . Imaging studies ; MRI was done to 78 patients seventy four of them were found to have abnormal images , X-ray was done to 69 patients thirty six of them were found to have abnormal image . Laboratory tests including the full blood count, E.S.R, urea and electrolytes, blood glucose and urinalysis were done to all the patients. Liver chemistry, B12, bone marrow and other investigations were done Cerebrospinal fluid analysis was abnormal in all patients with multiple sclerosis, 18 patients with acute inflammatory demyelinating polyneuropathy 9 patients with acute transverse myelitis and two patients with chronic inflammatory demyelinating polyneuropathy.