A Retrospective Study Of Non-Traumatic Paraplegia

Objective: (1)To explore clinical characteristics of non-traumatic paraplegia, in order to improve diagnosis level of this syndrome. (2)To explore appropriate application of auxiliary examinations in non-traumatic paraplegia patients, avoid delaying and unnecessary examinations.Methods: 50 patients suffering from non-traumatic paraplegia from January, 2004 to December, 2006 were retrospectively analyzed. including the causes,the characteristics of auxiliary examinations and consequences of inappropriate auxiliary examinations in these patients.Results: (1) There are 24 male and 26 female among the 50 cases, varying in age from 13 to 72, average age 43±8.8.Acute, subacute, chronic paraplegia are 16 cases, 7 cases, 27 cases respectively. 11 cases manifest complete paraplegia and the others are incomplete paraplegia. (2)The pathological location of 50 cases were found as follow: 21 cases (42%) of the spinal cord, 8 cases (16%) of vertebral column, 6 cases (12%) of peripheral nerve, 5 cases (10%) of neuromuscular junction and muscle, The cause of disease include demyelinate, vascular, degeneration, hereditary disease, infection, metabolism and poison, functional paraplegia. the ratio of them is 14%, 10%, 10%, 10%, 8%,8%, 4 % respectively。(3) 35 patients have MRI scan, 29 case of disease of spinal cord and vertebral column all scaned, 25 cases discovered pathologic changes, being up to 86%, 28 patients have CSF check, 22 cases of the CSF biochemical is abnormal and 14 cases of the CSF routine is abnormal. 3 patients have EMG examination, 5 cases sign muscle damage and 8 cases peripheral nerve damage.(4)In present study, 8 of 50 cases (16%) used inappropriate auxiliary examinations. 5 cases have unnecessary examinations and 3 cases omit important examinations.Conclusion: (1) In clinical practice, most non-traumatic paraplegia are chronic course and incomplete paraplegia. Diseases of spinal cord and vertebral column are the main pathological location of non-traumatic paraplegia, others include peripheral nerve disease, neuromuscular junction and muscle, The cause of disease include demyelinate, vascular, degeneration, hereditary, infection, metabolism and poisoning, functional paraplegia.. (2) The diagnosis of non-traumatic paraplegia needs detailed history taking and careful physical examination, selection of reasonable auxiliary examinations. inappropriate auxiliary examination often were performed while routine examinations were neglected. It is vital for diagnosis in non-traumatic paraplegia patients that clinicians realize the significance of auxiliary examinations and the importance of medical economics. (3) It is very important for non-traumatic paraplegia patients to be diagnosed in time and to be promptly treated.