HTLV Myelopathy

2013 ◽  
Author(s):  
Aaron E. Miller ◽  
Teresa M. DeAngelis
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Spastic Paraparesis ◽  
Tropical Spastic Paraparesis ◽  
Diagnostic Approach ◽  
Key Points

Infection due to the human T-lymphocytic 1 (HTLV-1) virus can result in a myelopathy involving the thoracolumbar spinal cord, which typically manifests clinically as a spastic paraparesis—hence its alternative moniker tropical spastic paraparesis. In this chapter, we summarize the diagnostic approach to a patient with a spastic paraparesis and the key points, which assist in narrowing down the lengthy differential diagnosis to HTLV-1.

scholarly journals Two Babinski signs in seropositive (HAM) and seronegative tropical spastic paraparesis

2008 ◽  
Vol 66 (3b) ◽  
pp. 695-697 ◽  
Author(s):  
Fidias E. Leon-Sarmiento ◽  
Andres Calderon ◽  
Hernan G. Hernandez
Keyword(s):  
Spinal Cord ◽  
Spastic Paraparesis ◽  
Tropical Spastic Paraparesis ◽  
Disease Pathogenesis ◽  
Platysma Muscle ◽  
Multistep Process

Tropical spastic paraparesis (TSP) may or may not be associated to HTLV-I antibodies and is usually characterized by clinical and pathological spinal cord abnormalities at thoracic levels. We present here five Brazilian patients who had typical chronic idiopatic spastic paraparesis; two of them were HTLV-I seropositive (HAM) and three HTLV-I seronegative (TSP) - associated-myelopathy. Three out of these five patients also displayed clinical supraspinal involvement, indeed, platysma muscle hypotrophy or atrophy (the Babinski plus sign). These findings support the view that clinical involvement in HAM and TSP is wider than the spinal cord abnormalities usually considered. Possible non-infectious co-factors (e.g., mycotoxins) may be involved in disease pathogenesis in a multistep process of viruses, toxins and environment which may account for serological differences found in this group of patients.

scholarly journals Neuropathology of two Brazilian autopsied cases of tropical spastic paraparesis / HTLV-I associated myelopathy (TSP/HAM) of long evolution

2002 ◽  
Vol 60 (3A) ◽  
pp. 531-536 ◽  
Author(s):  
Carlos Maurício de Castro-Costa ◽  
René Dom ◽  
Herwig Carton ◽  
Patrick Goubau ◽  
Terezinha de Jesus Teixeira Santos ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Grey Matter ◽  
Spastic Paraparesis ◽  
Tropical Spastic Paraparesis ◽  
Spinal Cord Atrophy ◽  
Thoracic Cord

We report on a neuropathological analysis of two cases of TSP/HAM originating from Brazil. These two cases had, respectively, an evolution of 13 and 40 years. The main neuropathological findings consisted of spinal cord atrophy, mainly the lower thoracic cord, diffuse degeneration of the white and grey matter, rare foci of mononuclear and perivascular cuffs, and hyaline hardening of arteriolae. The supraspinal structures were normal, excepting for a slight gliosis in the cerebellum. An analysis on the long evolutive cases as described in the literature is outlined in this study.

HTLV-I-Like viral particles in spinal cord cells in jamaican tropical spastic paraparesis

1988 ◽  
Vol 23 (S1) ◽  
pp. S185-S187 ◽  
Author(s):  
Pawel P. Liberski ◽  
Pamela Rodgers-Johnson ◽  
Guendra Char ◽  
Pedro Piccardo ◽  
Clarence J. Gibbs ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spastic Paraparesis ◽  
Tropical Spastic Paraparesis ◽  
Viral Particles

High signal in the spinal cord on T2-weighted images in rapidly progressive tropical spastic paraparesis

2001 ◽  
Vol 43 (3) ◽  
pp. 231-233 ◽  
Author(s):  
M. Watanabe ◽  
T. Yamashita ◽  
A. Hara ◽  
T. Murakami ◽  
Y. Ando ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spastic Paraparesis ◽  
Tropical Spastic Paraparesis ◽  
High Signal ◽  
T2 Weighted Images

scholarly journals Quantifying spinal cord cross-sectional area in HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP)

Retrovirology ◽  
2014 ◽  
Vol 11 (Suppl 1) ◽  
pp. P22 ◽  
Author(s):  
Winston Liu ◽  
Anshika Bakshi ◽  
Raya Massoud ◽  
Giovanna S Brunetto ◽  
Daniel S Reich ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spastic Paraparesis ◽  
Cross Sectional Area ◽  
Tropical Spastic Paraparesis ◽  
Sectional Area ◽  
Cross Sectional

scholarly journals Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)

1999 ◽  
Vol 57 (2A) ◽  
pp. 284-287 ◽  
Author(s):  
ABELARDO DE QUEIROZ-CAMPOS ARAÚJO ◽  
ANA CLAÚDIA CELESTINO BEZERRA LEITE ◽  
ANDRÉ LUIZ DOS ANJOS DE OLIVEIRA ◽  
CRISTIANE RIBEIRO DE ALMEIDA AFONSO ◽  
JULIANA PIES
Keyword(s):  
Spinal Cord ◽  
Clinical Picture ◽  
Spastic Paraparesis ◽  
Tropical Spastic Paraparesis ◽  
Type I ◽  
Diagnostic Challenge ◽  
Chiari Type 1 Malformation ◽  
Human T Cell ◽  
Magnetic Resonance Imaging Mri ◽  
Chronic Myelopathy

Human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy / tropical spastic paraparesis (HAM/TSP) is the most common chronic myelopathy in Brazil. We present the case of a 53 year old man that fulfilled the diagnostic criteria for HAM/TSP but had at the magnetic resonance imaging (MRI) of the spinal cord evidences of syringohydromyelia at the C6-C7 and D2-D7 levels along with Chiari type 1 malformation. The clinical picture was more typical of HAM/TSP than of syringohydromyelia, which was probably asymptomatic. The present case clearly demonstrates that serology and neuroimaging should be always used together. We conclude that, specially in places where HTLV-I is endemic, every patient with a spastic paraparesis, even with a radiological picture suggestive of a structural spinal cord lesion, should have a screening test for HTLV-I. The clinical picture must dictate the final direction of the diagnosis.

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