Abstract

Background: Non-compressive myelopathy (NCM) has a wide temporal and clinical profile and etiology that varies over different geographical locations. It constitutes a sizeable proportion of cases admitted in medicine and neurology ward. The etiology may vary according to age, geographical location, food habits, and other associated factors. There remains a great deal of heterogeneity in clinical features and imaging findings. Objectives: To evaluate etiological and radiological correlation in diagnosed cases of NCM. Material and Methods: This study was conducted in 73 patients of NCM admitted in Bangur Institute of Neuroscience, Kolkata, between August 2009 and 2012. The patients were evaluated clinically, and relevant laboratory, electrophysiological and radiological investigations were conducted.
Results: In the 73 patients (M:F: 50:23) evaluated, the mean age was 32 years (range 16-48 years). Etiology was established in 66 (90.4%) cases and these are acute transverse myelitis (ATM) (post infectious) in 30 (41.1%); multiple sclerosis (MS) in 10 (13.7%); Vitamin B12 deficiency in 9 (12.3%); tubercular myelitis in 6 (8.2%); neuromyelitis optica (NMO) in 4 (5.5%), sarcoidosis in 3 (4%), vascular in 1 (1.3%); hereditary spastic paraplegia in 1 (1.3%); post-radiation myelitis in 1 (1.3%), and post lightening myelitis in 1 (1.3%).
Conclusions: Post-infectious ATM is the most common cause of NCM followed by MS. Vitamin B12 deficiency is the third common cause of myelopathy prevalent in predominantly in vegetarian community. Acute tubercular myelitis has been found to be an important cause of NCM in this region.