3.7.6
Acute Myelopathy
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 3, Central Nervous System Conditions.
Clinical Description
Patients present with a sudden onset of paraparesis, with associated sensory loss, i.e., a sensory level may be found. Incontinence and autonomic instability may be present.
There are numerous causes for this condition, and it is important to exclude neoplastic and infectious conditions, i.e., granulomas and abscesses, causing external compression of the spinal cord. Lesions, such as intervertebral disk prolapse, and mass lesions below the spinal cord may present with cauda equina syndrome. These cases usually have asymmetrical weakness but may have saddle anesthesia and sphincter involvement alone. Incontinence is a marker of severity.
Complications and Referral Criteria
- All patients require urgent imaging.
- All patients to rehabilitation services before and/or after medical or surgical intervention.
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