HTLV-1-associated myelopathy or tropical spastic paraparesis
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Clinic
- HAM/TSP is a slowly progressive viral immune-mediated disorder of the spinal cord caused by HTLV-1
- HAM/TSP is a progressive disease of CNS that causes [1]
- It is mainly defined as a chronic spastic paraparesis + Minor sensory signs.
- The onset is insidious with often gait disturbance and urinary symptoms.
- Weakness or paralysis of legs
- Low back pain
- Urinary symptoms
Lower limb
- HAM/TSP is an upper motor neuron syndrome affecting primarily lower extremities. [2]
- Spastic weakness of both legs
- Extensor plantar responses
- Bilateral symmetric loss of position and vibratory sensation in feet.
- Achilles tendon reflexes are often absent.
Urinary symptoms
- Urinary incontinence
- Urgency
- In more than 90% of the cases, the neurological features involve: spasticity and/or hyperreflexia of the lower extremities, urinary bladder disturbance, lower extremity muscle weakness
- In 50% of the cases, sensory disturbances with low back pain.
- Central functions and cranial nerves are usually spared. [3]
- ↑ Michael Rubin , MDCM, New York Presbyterian Hospital-Cornell Medical Center Last review/revision May 2021 | Modified Sep 2022
- ↑ Medscape Reference
- ↑ Gessain A, Mahieux R. Tropical spastic paraparesis and HTLV-1 associated myelopathy: clinical, epidemiological, virological and therapeutic aspects. Rev Neurol (Paris). 2012 Mar;168(3):257-69. doi: 10.1016/j.neurol.2011.12.006. Epub 2012 Mar 7. PMID: 22405461.