Acute Non-Traumatic Paraparesis: A Comprehensive Analysis of Aetiology and Clinical Profile in an Indian Subpopulation.

ABSTRACT

Background and Objectives: This study was performed in a tertiary care hospital in western India. Our aim was to understand and analyze the clinical profile and causes of acute non-traumatic paraparesis and correlate them with relevant biochemical and radiological investigations. Methods: 100 cases of acute nontraumatic paraparesis admitted over a period of three years were studied. Data on age, sex, presenting symptoms, clinical signs and medical investigations was analyzed critically. This study used the mean and the median as measures of central tendency and standard deviation as a measure of dispersion. Results: Incidence of acute non-traumatic paraparesis was found to be the highest in the third and fourth decade of life (36% of cases). Incidence among males (54%) and females (46%) was fairly equal. An inability to walk (72%) or a difficulty in walking (28%) were the chief presenting symptoms. 76% of cases presented in a stage of spinal shock. Tuberculosis was the commonest cause (40%), followed by acute transverse myelitis (26%). 50% of cases had compressive myelopathy while 30% had non-compressive myelopathy. Investigations such as cerebrospinal fluid (CSF) analysis, nerve conduction studies and Magnetic Resonance Imaging (MRI) were useful in diagnosing the causes. Conclusion: The commonest cause of acute non-traumatic paraparesis was tuberculosis. Early use of the MRI scan helps to confirm etiology and site of lesion.