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DOI: 10.1590/0004-282X20160001
Clinical and epidemiological profiles of non-traumatic myelopathies
Perfil clínico e epidemiológico das mielopatias não-traumáticas
ABSTRACT
Non-traumatic myelopathies represent a heterogeneous group of neurological conditions. Few studies report clinical and epidemiological profiles regarding the experience of referral services.
Objective To describe clinical characteristics of a non-traumatic myelopathy cohort.
Method Epidemiological, clinical, and radiological variables from 166 charts of patients assisted between 2001 and 2012 were compiled.
Results The most prevalent diagnosis was subacute combined degeneration (11.4%), followed by cervical spondylotic myelopathy (9.6%), demyelinating disease (9%), tropical spastic paraparesis (8.4%) and hereditary spastic paraparesis (8.4%). Up to 20% of the patients presented non-traumatic myelopathy of undetermined etiology, despite the broad clinical, neuroimaging and laboratorial investigations.
Conclusion Regardless an extensive evaluation, many patients with non-traumatic myelopathy of uncertain etiology. Compressive causes and nutritional deficiencies are important etiologies of non-traumatic myelopathies in our population.
RESUMO
As mielopatias não-traumáticas representam um grupo heterogêneo de doenças neurológicas. Poucos estudos descrevem os perfis clínico e epidemiológico sobre a experiência de serviços de referência.
Objetivo Descrever as características clínicas de uma coorte de mielopatia não-traumática.
Método Os registros clínicos de 166 pacientes atendidos entre 2001 e 2012 foram revisados e variáveis epidemiológicas, clínicas e radiológicas foram compiladas.
Resultados O diagnóstico mais prevalente foi o de degeneração combinada subaguda (11,4%), seguido por mielopatia espondilótica cervical (9,6%), doenças desmielinizantes (9%), paraparesia espástica tropical (8,4%) e paraparesia espástica hereditária (8.4%). Aproximadamente 20% dos pacientes apresentaram mielopatia não-traumática de etiologia indeterminada, apesar da ampla investigação clínica, laboratorial e de neuroimagem.
Conclusão Independentemente da ampla avaliação, muitos pacientes com mielopatia não-traumática apresentam etiologia incerta. Causas compressivas e deficiências nutricionais permanecem como etiologias importantes de mielopatias não-traumáticas.
Publikationsverlauf
Eingereicht: 05. März 2015
Angenommen: 16. November 2015
Artikel online veröffentlicht:
06. September 2023
© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Ginsberg L. Disorders of the spinal cord and roots. Pract Neurol. 2011;11(4):259-67. doi:10.1136/practneurol-2011-000069
- 2 Schwenkreis P, Pennekamp W, Tegenthoff M. Differential diagnosis of acute and subacute non-traumatic paraplegia. Dtsch Arztebl. 2006;103(44):A2948-54.
- 3 Schmalstieg WF, Weinshenker BG. Approach to acute or subacute myelopathy. Neurology. 2010;75(18 Suppl 1):S2-8. doi:10.1212/WNL.0b013e3181fb3638
- 4 Brinar VV, Habek M, Zadro I, Barun B, Ozretić D, Vranjes D. Current concepts in the diagnosis of transverse myelopathies. Clin Neurol Neurosurg. 2008;110(9):919-27. doi:10.1016/j.clineuro.2008.07.002
- 5 Jacob A, Weinshenker BG. An approach to the diagnosis of acute transverse myelitis. Semin Neurol. 2008;28(1):105-20. doi:10.1055/s-2007-1019132
- 6 Hess ChW. [Non-traumatic acute transverse spinal cord syndromes]. Praxis (Bern 1994). 2005;94(30-31):1151-9. German.
- 7 Vitzthum HE, Dalitz K. Analysis of five specific scores for cervical spondylogenic myelopathy. Eur Spine J. 2007;16(12):2096-103. doi:10.1007/s00586-007-0512-x
- 8 Wong SH, Boggild M, Enevoldson TP, Fletcher NA. Myelopathy but normal MRI: where next? Pract Neurol. 2008;8(2):90-102. doi:10.1136/jnnp.2008.144121
- 9 Lekoubou Looti AZ, Kengne AP, Djientcheu VP, Kuate CT, Njamnshi AK. Patterns of non-traumatic myelopathies in Yaoundeé (Cameroon): a hospital based study. J Neurol Neurosurg Psychiatry. 2010;81(7):768-70. doi:10.1136/jnnp.2009.177519
- 10 Moore AP, Blumhardt LD. A prospective survey of the causes of non-traumatic spastic paraparesis and tetraparesis in 585 patients. Spinal Cord. 1997;35(6):361-7. doi:10.1038/sj.sc.3100422