Evaluation of causes of acute onset paraparesis in a tertiary care centre in South India

Background: Paraparesis is a complex condition that presents with unique challenges and people living with paraparesis can lead fulfilling lives with the right support and rehabilitation. This study aimed to determine the causes of acute onset paraparesis presenting to emergency department. Methods: A hospital-based cross-sectional study done for a period of 12 months in 90 people attending a tertiary care hospital in Siddipet, Telangana. Patients aged less than 14 years, pregnant and lactating mothers and patients who were not willing to participate in the study were excluded. Preliminary data was recorded, followed by clinical examination and necessary relevant laboratory and radiological investigations were done. Results: After complete evaluation, 33% of the people were found to have hypokalemic periodic paralysis, 30% were having Guillain Barre syndrome, 4% people were diagnosed with traumatic vertebral fractures and 3% of the people were found to have polymyositis. Rest of the people were having extramedullary Tumors, intervertebral disc prolapses, cauda equina syndrome, conus medullaris, paraneoplastic syndromes, neuromyelitis optica, transverse myelitis and multiple sclerosis. Conclusions: Acute onset paraparesis must be evaluated swiftly starting with metabolic abnormalities which seem to be the most commonly encountered cause followed by imaging modalities, keeping in mind a few conditions related to spinal cord. Early detection and treatment are important to avoid grave consequences. It is imperative that atraumatic causes must also be taken into account besides the traumatic etiology, as there can be a significant improvement in their quality of life with timely medical attention and prompt treatment.