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; 26.3% had 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.