PATTERN OF SPINAL CORD NON-COMPRESSION SYNDROMES; TYPIFIED BY NEUROMYELITIS OPTICA: THE EXPERIENCE IN SOKOTO

*Dr. Balarabe S. A.

ABSTRACT

Background: Myelopathy is used in describing neurologic deficit related to the lesions affecting the spinal cord. When the mechanism of injury is due to inflammatory changes, it is known as myelitis. Neuromyelitis optica (NMO) is one of the disabling inflammatory lesions of the central nervous system (CNS) and is presumed to be of putative autoimmune aetiology, that commonly affects both spinal cord and optic nerves. Clinically, NMO is subcategorized into cases of simultaneous optic neuritis (ON) and myelitis, cases of successive myelitis and later optic neuritis and limited forms such as single or recurrent events of longitudinally extensive myelitis (LETM) or recurrent ON. More rarely, patients may present with brain stem encephalitis. The aim of this study was to investigate the frequency of non-compressive spinal cord lesions in the North-western region of Nigeria. Material and Method: This was a retrospective study carried out in neurology unit of Usmanu Danfodiyo University Teaching Hospital Sokoto over the period of five year between January 2010-December 2014. Where patients at least 15 year of age were enrolled. The data were extracted from patient case folder. The data were analyzed for Frequency distribution, Age, Sex as well as cross tabulation of Age and Sex, Sex and diagnosis. Result: A total of 22 cases of Non-compressive myelopathies were clinically diagnosed within the study period, this accounted for 0.9% of all the neurological disorders. Out of this 81.2% (18/22) were females, and 18.2% (4/22) were males, with female to male ratio of 4.5:1. The mean age of patient was 58.3, with SD±18.5 and the age range of 17- 81 year. Neuromylitis optical and transverse myelitis accounted for 36.4% (8/22) each, followed by sub-acute combine degeneration of the cord 18.2% (4/22), while cervical cord infarction accounted for 9.1% (2/22). Conclusion: This study revealed that Neuromylitis optica and isolated transverse myelitis are the most common non-compressive myelopathies in our center. Therefore, clinicians practicing in developing countries like Nigeria must be aware of the many potential etiologies for spinal cord diseases, and should pursue an ordered, efficient, and cost-effective evaluations based on the patient's clinical history and examinations. This call for all hands to be on deck among policy makers in the region. Additionally, there is equally the need for modern neuro-diagnostic facilities such as Magnetic Renance Imaging (MRI), to be made available in our various hospitals in the region.

Keywords: Spinal cord compresion syndrome, Neuromyelitis optica, Transverse Myelitis, Pattern