Etiologic Profile of Non-Compressive Myelopathy in a Large Tertiary Care Centre of North West Part of India

The term myelopathy describes pathologic condition that cause damage or dysfunction of spinal cord, meningeal or perimeningeal space. Here we tried to determine the etiological profile of non-compressive myelopathies in a tertiary care centre of north west India. OBJECTIVES-1. To study the clinical and radiological features of non- compressive myelopathies. 2. To determine the causes of non-compressive myelopathies. MATERIAL AND METHOD-An observational study was carried out in the neurology department of a large tertiary care centre of north west India from May 2018 to June 2020.Total number of patients were 70. MRI brain and spine along with visually evoked potential test and cerebrospinal fluid analysis were done in all 70 cases.RESULTS- Out of 70 patients, 50 (71.4 %) were males and 20 (28.57 %) females. Mean age of presentation was 31.95 years. Patients were subdivided on the basis of age into groups - < 18 years (15 patients-21.4 %), 18-45 years (42 patients-60 %) and >45 years (13 patients-18.5 %).Onset of illness was acute to sub-acute in nature in all the cases. Bladder and bowel involvement was seen in maximum cases (55 cases-78.6 %).Patients found to have long segment myelitis (50 patients-71.4 %), short segment myelitis (13 patients - 18.5 %) and spinal cord without changes (7 patients-10 %). Demyelinating illness was most common in occurrence- 20 cases out of 70 (28.6 %) comprising 10 NMO positive (14.3 %), 8 MOG positive (11.4 %) and 2 multiple sclerosis cases (2.8 %). Six cases (8.6 %) each of tubercular myelitis and post infectious (non-tubercular) ATM including 1 case (1.4 %) of post herpetic myelitis were found along with five cases (7.1 %) of sub acute combined degeneration and 2 cases (2.9 %) of spinal AVM (Arterio-venous malformation) 31 (44.3 %) cases remained undiagnosed due to non-affordability to further blood tests.CONCLUSION-Most common cause was found to be demyelinating illness followed by tubercular, post infectious and vitamin B12 deficiency.