title: Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India.
abstract: BACKGROUND
  The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21stcentury have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic.
  
  
  OBJECTIVE
  To find causes of noncompressive myelopathy in a tertiary care hospital of Northeast India.
  
  
  METHODS
  An observational study was carried out in the Neurology Department of Gauhati Medical College, Guwahati, from September 2013 to February 2016. Patients of noncompressive myelopathies who underwent magnetic resonance imaging (MRI) of the spine were segregated into two categories: acute-to-subacute myelopathy (ASM) and chronic myelopathy (CM). In addition to routine blood tests, chest X-ray, urinalysis, and visual evoked potentials, investigations included MRI of the brain, cerebrospinal fluid analysis, and immunological, infectious, and metabolic profile based on the pattern of involvement.
  
  
  RESULTS
  The study had 151 patients (96 ASM and 55 CM) with a median age of 35 years and male: female ratio 1.4:1. The causes of ASM were neuromyelitis optica spectrum disorder (23), multiple sclerosis (MS) (8), systemic lupus erythematosus (1), Hashimoto's disease (1), postinfectious acute disseminated encephalomyelitis (6), postinfectious myelitis (8), infections (9), spinal cord infarct (5), and electrocution (1). The causes of CM were MS (1), probable or possible sarcoidosis (7), mixed connective tissue disease (1), Hashimoto's disease (2), infections (9), Vitamin B12deficiency (4), folate deficiency (2), hepatic myelopathy (2), radiation (11), and paraneoplastic (1). No etiology could be found in 48 (31.8%) patients (34 ASM and 14 CM). In 21/96 (21.9%) patients of ASM, acute transverse myelitis was idiopathic based on current diagnostic criteria.
  
  
  CONCLUSIONS
  Underlying etiology (demyelinating, autoimmune, infectious, vascular, metabolic disorder, or physical agent) was found in 68% patients of noncompressive myelopathy.
authors.affiliation: Department of Neurology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Kayal
authors.affiliation: Department of Neurology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
authors.forename: Munindra
authors.initials: M
authors.lastname: Goswami
authors.affiliation: Department of Neurology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
authors.forename: Marami
authors.initials: M
authors.lastname: Das
authors.affiliation: Department of Neurology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
authors.forename: Lakhshya Jyoti
authors.initials: LJ
authors.lastname: Basumatary
authors.affiliation: Department of Neurology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
authors.forename: Suvorit Subhas
authors.initials: SS
authors.lastname: Bhowmick
authors.affiliation: Department of Neurology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
authors.forename: Baiakmenlang
authors.initials: B
authors.lastname: Synmon
keywords: Neuromyelitis optica; noncompressive myelopathies; transverse myelitis