Profile and Outcome of Non-Traumatic Paraplegia in Kano; Northwestern Nigeria

Aim: This study was aimed to identify the clinical and radiological profile of non-traumatic paraplegia and the various etiologies associated with the condition. Materials and Methods: A review of the clinical and radiological presentations of adult patients presenting with non-traumatic paraplegia managed at the Aminu Kano Teaching Hospital (AKTH) and Murtala Specialist Hospital (MMSH); Kano; from June 2006 to November 2009 was carried out. Patients underwent a detailed clinical evaluation followed by laboratory investigation and neuroimaging studies and were followed up for 9 months to asses outcome and complications. Results: 98 patients with non-traumatic paraplegia consisting of 71 males and 27 females (M:F: 5:2) were seen. The age range of the patients was between 16 and 76 years; with a mean age of 40 years (SD = 15.3) years; 54 (55) of the patients presented after 2 months of the onset of paraplegia. The commonest symptoms were weakness of the lower limbs (100); loss of sensation (55); sphincteric disturbance (50) radicular pain and paresthesia (38.4); back pain (21.4) and erectile dysfunction (40). All the patients had X-ray of the spine; 26.3had Magnetic Resonance Imaging (MRI) spine. The commonest etiological factors were tuberculosis (TB) (44.4); transverse myelitis (13.1); Guillain-Barre syndrome (9.1); metastatic spinal disease (4); and HIV myelopathy (4). However; the cause could not be identified in 14 (14) of the patients. The commonest site of affectation in those with TB spine was lower thoracic (53.8) and upper lumbar (23.1) vertebrae. Conclusion: Clinical profile of non-traumatic paraplegia in Kano; northwestern Nigeria; is similar to that reported elsewhere in Africa; with spinal tuberculosis and transverse myelitis accounting for over half the cases

Gastrointestinal complications in stroke survivors.

The objective of this study was to highlight the gastrointestinal problems that occur in stroke survivors, which may also reduce their quality of life. Stroke patients admitted over an 18-month period were evaluated for common gastrointestinal symptoms as well as type and site of stroke. Symptoms evaluated included vomiting, dysphagia, constipation, masticatory difficulties and sialorrhea among others. Similar symptoms were sought for among controls. There were 54 experimental and 46 control subjects consisting of 25 (46.3%) men and 29 (53.7%) women and 32 (69.6%) men and 14 (30.4%) women respectively. The dominant gastrointestinal symptom was constipation 14 (25.9%), followed by masticatory difficulty 11 (20.4%). Other significant gastrointestinal (GI) symptoms and signs were incomplete bowel evacuation, fecal incontinence, sialorrhea, and dysphagia. There was no significant difference in GI symptoms in either sex, site or type of stroke, except that constipation and incomplete evacuation were commoner in ischaemic stroke. It is advocated that feeding and bowel care should be instituted among stroke patients.