N J Fidèle1, A Amanuel2. 1. Internal Medicine Department, Neurology unity, Butare University Teaching Hospital, Rwanda. 2. Department of Neurology, Addis Ababa University, Ethiopia.
Abstract
STUDY DESIGN: This is a retrospective hospital-based study. OBJECTIVES: The study aimed at a better understanding of the etiology, clinical presentation and treatment outcome of nontraumatic myelopathies in Ethiopian patients. SETTING: Etiologies of nontraumatic myelopathies have not been evaluated extensively in most sub-Saharan African countries. The available studies in this region were conducted before the widespread clinical use of modern neuroimaging modalities. This study was conducted in Addis Abba, Ethiopia. METHODS: We retrospectively analyzed medical files of patients with a diagnosis of myelopathy (age ⩾13 years) admitted or followed up at Tikur Anbesa Hospital between 1 January 2010 and 30 June 2013. RESULTS: Records of 105 patients were analyzed. The male to female ratio was 1.7. The mean age was 38.5 years. Weakness, sensory symptoms (including sensory level), back pain and sphincter dysfunction were the dominant features. Etiologies were dominated by spinal tuberculosis (23.8%) followed by spinal cord neoplastic lesions (primary (10.5%) and secondary neoplasms 8.6%). Other important etiological causes were transverse myelitis (16.2%), degenerative cervical spondylotic myelopathy (15.2%), amyotrophic lateral sclerosis (4.8%) and neuromyelitis optica/multiple sclerosis (3.8%). The mortality rate was 9.5%. Among the patients who died, 40% had chest infection as a complication and 70% presented with complete weakness. CONCLUSION: Infections remain a major cause of spinal cord disease, and tuberculosis constitutes public health target for reducing the incidence of myelopathies. Early detection and treatment of complications may reduce the high rate of mortality and morbidity observed.
STUDY DESIGN: This is a retrospective hospital-based study. OBJECTIVES: The study aimed at a better understanding of the etiology, clinical presentation and treatment outcome of nontraumatic myelopathies in Ethiopian patients. SETTING: Etiologies of nontraumatic myelopathies have not been evaluated extensively in most sub-Saharan African countries. The available studies in this region were conducted before the widespread clinical use of modern neuroimaging modalities. This study was conducted in Addis Abba, Ethiopia. METHODS: We retrospectively analyzed medical files of patients with a diagnosis of myelopathy (age ⩾13 years) admitted or followed up at Tikur Anbesa Hospital between 1 January 2010 and 30 June 2013. RESULTS: Records of 105 patients were analyzed. The male to female ratio was 1.7. The mean age was 38.5 years. Weakness, sensory symptoms (including sensory level), back pain and sphincter dysfunction were the dominant features. Etiologies were dominated by spinal tuberculosis (23.8%) followed by spinal cord neoplastic lesions (primary (10.5%) and secondary neoplasms 8.6%). Other important etiological causes were transverse myelitis (16.2%), degenerative cervical spondylotic myelopathy (15.2%), amyotrophic lateral sclerosis (4.8%) and neuromyelitis optica/multiple sclerosis (3.8%). The mortality rate was 9.5%. Among the patients who died, 40% had chest infection as a complication and 70% presented with complete weakness. CONCLUSION:Infections remain a major cause of spinal cord disease, and tuberculosis constitutes public health target for reducing the incidence of myelopathies. Early detection and treatment of complications may reduce the high rate of mortality and morbidity observed.