Clinical and epidemiological profiles of non-traumatic myelopathies

Pinto, Wladimir Bocca Vieira de Rezende; Souza, Paulo Victor Sgobbi de; Albuquerque, Marcus Vinicius Cristino; Dutra, Lívia Almeida; Pedroso, José Luiz; Barsottini, Orlando Graziani Póvoas

doi:10.1590/0004-282x20160001

Cited by 8 publications

(3 citation statements)

References 8 publications

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“…A Brazilian multicentre cohort study reported that cobalamin, vitamin B12 and copper deficiencies were common among patients with non-traumatic myelopathy. 50 Furthermore, a single-centre cross-sectional study, of 106 patients with chronic SCI, showed that vitamin B12 deficiency was present in 67% of patients and correlated with a longer duration of SCI. 51 Macrocytic anaemia was present in 17% of subjects with subnormal B12 levels.…”

Section: Resultsmentioning

confidence: 99%

The Role of Nutrition in Degenerative Cervical Myelopathy: A Systematic Review

Partha-Sarathi

Mowforth

Sinha

et al. 2021

Nutr Metab Insights

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Introduction: Degenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord impairment worldwide, encompassing chronic compression of the spinal cord, neurological disability and diminished quality of life. Evidence on the contribution of environmental factors is sparse; in particular, the role of nutrition in DCM is unknown. The objective of this review was to assess the effect of nutrition on DCM susceptibility, severity and surgical outcome. Methods: A systematic review in MEDLINE and Embase was conducted following PRISMA guidelines. Full-text papers in English papers, focussing on cervical myelopathy and nutrition, published before January 2020 were considered eligible. Quality assessments were performed using the GRADE assessment tool. Patient demographics, nutritional factor and DCM outcomes measures were recorded. Relationships between nutritional factors, interventions and disease prognosis were assessed. Results: In total, 5835 papers were identified of which 44 were included in the final analysis. DCM patients with pathological weight pre-operatively were more likely to see poorer improvements post-surgically. These patients experienced poorer physical and mental health improvements from surgery compared to normal weight patients and were more likely to suffer from post-operative complications such as infection, DVT, PE and hospital readmissions. Two trials reporting benefits of nutritional supplements were identified, with 1 suggesting Cerebrolysin to be significant in functional improvement. An unbalanced diet, history of alcohol abuse and malnourishment were associated with poorer post-operative outcome. Conclusion: Although the overall strength of recommendation is low, current evidence suggests nutrition may have a significant role in optimising surgical outcome in DCM patients. Although it may have a role in onset and severity of DCM, this is a preliminary suggestion. Further work needs to be done on how nutrition is defined and measured, however, the beneficial results from studies with nutritional interventions suggest nutrition could be a treatment target in DCM.

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Section: Resultsmentioning

confidence: 99%

The Role of Nutrition in Degenerative Cervical Myelopathy: A Systematic Review

Partha-Sarathi

Mowforth

Sinha

et al. 2021

Nutr Metab Insights

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“…Depending on the level(s) of the spinal cord involved, patients will typically develop acute paraparesis or quadriparesis. Inflammatory conditions that can result in acute myelopathy include demyelinating diseases such as multiple sclerosis (MS), neuromyelitis optica (NMO), and acute disseminated encephalomyelitis (ADEM); systemic inflammatory conditions such as systemic lupus erythematous, Sjogren syndrome, mixed connective tissue disorder, Behcet disease, and sarcoidosis; and infectious diseases [8].…”

Section: Discussion Of Procedures By Variant Variant 1: Acute Onset Myelopathy Initial Imagingmentioning

confidence: 99%

“…A variety of cysts and benign neoplasms can also compress the cord; they tend to arise within the intradural compartment. The most common of these are nerve sheath tumors, meningiomas, and arachnoid adhesions/cysts [4][5][6][7][8][9][10].…”

Section: Summary Of Literature Review Introduction/backgroundmentioning

confidence: 99%

ACR Appropriateness Criteria® Myelopathy: 2021 Update

Imaging¹,

Agarwal

Shah

et al. 2021

Journal of the American College of Radiology

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Myelopathy is a clinical diagnosis with localization of the neurological findings to the spinal cord, rather than the brain or the peripheral nervous system, and then to a particular segment of the spinal cord. Myelopathy can be the result of primary intrinsic disorders of the spinal cord or from secondary conditions, which result in extrinsic compression of the spinal cord. While the causes of myelopathy may be multiple, the acuity of presentation and symptom onset frame a practical approach to the differential diagnosis. Imaging plays a crucial role in the evaluation of myelopathy with MRI the preferred modality.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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Spasticity distribution and severity in individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis

et al. 2020

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In individuals with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), spasticity is one of the main symptoms. The neurological signs of the disease are well defined, but details of how spasticity appears in these individuals have not been well explored. To describe spasticity location and severity of HAM/TSP individuals. Cross-sectional study with individuals older than 18 years, diagnosed with HAM/TSP and with lower limb spasticity. Pregnant women, individuals with other associated neurological diseases, and those using antispastic drugs were not included. Spasticity was assessed by the Modified Ashworth Scale (MAS), applied to the abductor, adductor, flexor, and extensor muscles of the hips, flexors, and extensors of the knees, dorsiflexors, plantiflexors, evertors, and inverters of the foot. Thirty participants were included. The plantiflexor muscles (90%), knee extensors (80%), knee flexors (63,3%), and adductors (50%) were most frequently affected by spasticity. Twenty-three (76.7%) individuals had mixed spasticity, 5 (16.7%) with distal spasticity and 2 (6.7%) with proximal spasticity. MAS was similar between the lower limbs in at least 6 of the 10 muscle groups of each individual. Spasticity was mostly mixed in the lower limbs, with more frequently mild severity. The individuals were partially symmetrical between the lower limbs. The most affected muscle groups were the plantiflexors, knee extensors and flexors and the hip adductors, consecutively, being predominantly symmetrical.

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Clinical and epidemiological profiles of non-traumatic myelopathies

Cited by 8 publications

References 8 publications

The Role of Nutrition in Degenerative Cervical Myelopathy: A Systematic Review

The Role of Nutrition in Degenerative Cervical Myelopathy: A Systematic Review

ACR Appropriateness Criteria® Myelopathy: 2021 Update

Spasticity distribution and severity in individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis

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