A CLINICAL STUDY OF NON-TRAUMATIC PARAPLEGIA IN PATIENTS ADMITTED IN ASSAM MEDICAL COLLEGE AND HOSPITAL.

Abstract

Background: Paraplegia is a common and an important cause of disablement in all age group and in both sexes. In the days of ancient medicine it was most problematic for the physicians and surgeons to treat the cases and they considered it as “Hopeless”( Edwin Smith Papyrus, Breasted, 1930) written 4000 years ago. Paraplegia is caused by variety of diseases of different etiology from cerebral cortex to muscles. But measures should be taken to diagnose every possible cause and to offer best modality of treatment to eliminate the sufferings of patients. Materials And Methods: 50 patients of non-traumatic paraplegia were studied at Assam Medical College and Hospital from July 2005 to June 2006. Patients underwent a detailed clinical evaluation followed by laboratory investigations and neuroimaging studies. In our study the maximum incidence was in Results: the 4th decade (32%), the next being in the third decade (26%). Out of 50 cases there were 38 males (76%) and 12 females (24%). The occupation of the patients were cultivators (24%), housewife (24%), laborer (18%), student (10%), clerk (8%), teacher (4%), driver (4%), businessman ( 2%), engineer (2%), peon ( 2%). Acute onset was observed in 18 cases (36%), subacute onset in 4 cases (8%) and insidious in 28 cases (56%). The etiologies were found to be Transverse myelitis (20%), L.G.B.S (20%), Pott's paraplegia (16%), Lumbar disc prolapse (16%), Spinal tumor ( 8%), dorsal disc prolapse (4%), spinal arachnoiditis (4%), radiation myelitis (4%). We thus Conclusion: conclude that the present study shows acute transverse myelitis to be the commonest cause and spinal tuberculosis the second most common etiology of non-traumatic paraplegia. The patterns of clinical presentation and incidences of paraplegia due to various etiologies in this study bear close resemblance to the ones described by other workers.