Patterns of non-traumatic myelopathies in Yaounde (Cameroon): a hospital based study.
BACKGROUND
The relative frequency of compressive and non-compressive myelopathies and their aetiologies have not been evaluated extensively in most sub-Saharan African countries. The case of Cameroon is studied.


METHODS
Admission registers and case records of patients in the neurology and neurosurgery departments of the study hospital were reviewed from January 1999 to December 2006.


RESULTS
224 (9.7% of all admissions) cases were non-traumatic paraplegia/paraparesis or tetraplegia/tetraparesis and 147 were due to myelopathies, representing 6.3% of all cases admitted during the study period and 65.6% of cases of paraplegia or tetraplegia; 88% were compressive myelopathies. Aetiologies were dominated by primary and secondary spinal tumours (mainly prostate carcinoma, lymphoma and liver carcinoma) that each accounted for 24.5% of cases. Other causes included spinal tuberculosis (12.9%), tropical spastic paraparesis (five positive for human T cell lymphotrophic virus (HTLV)-I and one for HTLV-II) (4.8%), spinal degenerative disease (4.1%), acute transverse myelitis (4.1%), HIV myelopathy (1.4%), vitamin B12 deficiency myelopathy and multiple sclerosis (0.7%). No aetiology was found in 21.1% of participants.


CONCLUSIONS
Myelopathies in our setting are dominated by spinal compressions. Metastasis is a leading cause of spinal cord compression with liver carcinoma being more frequent than reported elsewhere. Infections nevertheless remain a major cause of spinal cord disease and both cancers and infections constitute public health targets for reducing the incidence of myelopathies.
Lekoubou Looti
Alain Zingraff
AZ
Faculty of Medicine and Biomedical Sciences, Yaounde I, Hôpital Neurologique, 59 Bd Pinel, Lyon 69500, France. lekoub77@yahoo.com
Kengne
André Pascal
AP
Djientcheu
Vincent de Paul
Vde P
Kuate
Callixte T
CT
Njamnshi
Alfred K
AK
D000328:Adult; D001003:Anal Canal / Q000473:pathology; D002163:Cameroon / Q000453:epidemiology; D005260:Female; D006761:Hospitals; D006801:Humans; D007239:Infections / Q000150:complications / Q000453:epidemiology; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010264:Paraplegia / Q000209:etiology / Q000473:pathology; D011782:Quadriplegia / Q000209:etiology / Q000473:pathology; D012677:Sensation; D012737:Sex Factors; D013117:Spinal Cord Compression / Q000150:complications / Q000473:pathology; D013118:Spinal Cord Diseases / Q000150:complications / Q000453:epidemiology / Q000473:pathology*