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Clinical and demographic features of HTLV‐1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Rio de Janeiro, Brazil
Author(s) -
Araújo A. de QC.,
Alfonso C. R.,
Schor D.,
Leite A. C.,
AndradaSerpa M. J.
Publication year - 1993
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1993.tb04188.x
Subject(s) - tropical spastic paraparesis , myelopathy , medicine , serology , multiple sclerosis , pleocytosis , gastroenterology , surgery , cerebrospinal fluid , immunology , antibody , spinal cord , psychiatry
In Rio de Janeiro (RJ) most cases of paraparesis of obscure origin are associated with the human T‐cell lymphotropic virus type I (HTLV‐I). Thirty‐four consecutive patients with HTLV‐I‐associated myelopathy/tropical spastic paraparesis (HAM/TSP) from RJ were evaluated. Most patients came from low socio‐economic levels. There was no difference in terms of gender. The main affected racial group was white. A history of sexually transmitted diseases was a major risk factor for HAM/TSP and a positive serology for syphilis was found in 26.5% of the patients. The major clinical findings were of a spastic paraparesis with generalized brisk tendon jerks and bilateral Babinki's sign. Sensation was abnormal in 25 patients (73.5%) and five (14.7%) had a sensory level. Three patients (8.8%) had optic atrophy. The cerebrospinal fluid showed a lymphocytic pleocytosis with a mean total protein content of 0.4 g/litre, and an increased intrathecal IgG synthesis in 59.4% of patients. HAM/TSP and multiple sclerosis (MS) occur indigenously in RJ and some HAM/TSP cases can be sometimes confused with MS. Therefore we propose that, in places where MS coexist with HAM/TSP, HTLV‐I antibodies should be sought routinely in those MS suspected cases with prominent spastic paraparesis.