A Clinical Study of Myelopathy of Unknown Origin

Keimyung Medical Journal 1990;9(2):207-214.

원인불명의 척수병증(Myelopathy of Unknown Origin: MUO)에 관한 임상적 고찰

박성파; 이용희; 임정근; 이동국; 이상도; 서정규; 박영춘

Abstract

A clinical study was carried out in 41 patients with MUO(Myelopathy of Unknown Origin); who were admitted to the Keimyung University Dongsan hospital from January 1985 to March 1989 The results were as follows 1 Mean age at the time of admission was 44 years (from 22 to 69 years); and there were 32 men and 9 women (3 5 1) 2 The modes of onset were acute in 14 6%; subacute in 2 5% and chronic in 82 9% The clinical symptoms & signs were paresthesia(87 8% ); gait disturbance(70 7% ); motor weakness(65 9% );hyperreflexia(82 ) and Babinski sign(43 9%); and the most common type of sensory loss was the loss of all modahties(34 1%) which were pain; temperature; position and vibration; and the most common type of motor weakness was mild form(46 3%) 3 According to the neurologic examination; the sites of lesion were thoracic(439%);lumbar(415%) and cervical(14 6% ) in order of frequency and the most common type in cross sectional involvement was simultaneous involvement of many spinal tracts(46 3%) including the spinothalamic tract; corticospinal tract and posterior column The bilateral symmetric cord lesion was commonCTS^) 4 In the cerebrospinal fluid analysis; there were increased IgG m 4 of 36(111%) patients; increased IgG/al-bumin ratio in 10 of 27 (370%) patients and increased IgG index in 10 of 18(556%) patients 5 According to the electrophysiologic studies; abnormal findings which suggested the evidence of myelopathy were observed in 2 of 24 (138%) patients by median somatosensory evoked potentials and 2 of 5 (40%) patients by tibial somatosensory evoked potentials 6 After the treatment of ACTH for 14 days in 28 of 41 (683%) patients; the sensory and motor disturbances were improved in 53 6%; stationary in 393% and aggravated in 71% 7 After follow-up evaluation for average 44 months from onset; the clinical courses were stationary in * 463%; improved in 366%; aggravated in 14and recovered m 25% In the furture; the causes of MUO(Myelopathy of Unknown Origin) may be clarified by a long-term clinical follow-up; by the accurate electrophysiologic studies’ laboratory findings and diagnostic imagings; above all by the neuropathologic findings from the necroptic studies

Key Words: myelopathy, unknown origin, clinical study