Tropical spastic paraparesis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Tropical spastic paraparesis
Synonyms	HTLV-1 associated myelopathy (HAM)
Pronounce	N/A
Specialty	Neurology
Symptoms	Muscle weakness, spasticity, hyperreflexia, bladder dysfunction
Complications	N/A
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Human T-lymphotropic virus 1 (HTLV-1)
Risks	HTLV-1 infection, genetic predisposition, geographic location
Diagnosis	Blood test, MRI, cerebrospinal fluid analysis
Differential diagnosis	Multiple sclerosis, amyotrophic lateral sclerosis, spinal cord injury
Prevention	N/A
Treatment	Physical therapy, antiviral drugs, corticosteroids
Medication	N/A
Prognosis	Variable, often progressive
Frequency	Rare
Deaths	N/A

A disease caused by the human T-lymphotropic virus 1

Histopathological image of muscle tissue

Diagram of an immunoglobulin molecule

Tropical spastic paraparesis (TSP), also known as HTLV-1 associated myelopathy (HAM), is a progressive neurological disorder caused by the human T-lymphotropic virus 1 (HTLV-1). It primarily affects the spinal cord, leading to muscle weakness, spasticity, and other neurological symptoms.

Signs and symptoms

Tropical spastic paraparesis is characterized by progressive weakness and stiffness of the legs, leading to difficulty walking. Patients may also experience back pain, urinary incontinence, and erectile dysfunction. Sensory disturbances, such as numbness or tingling, can occur, although they are less common.

Causes

TSP is caused by infection with the human T-lymphotropic virus 1 (HTLV-1), a retrovirus that primarily infects T cells. The virus is transmitted through blood, sexual contact, and from mother to child via breastfeeding. Not all individuals infected with HTLV-1 develop TSP; the disease occurs in a small percentage of those infected.

Pathophysiology

The exact mechanism by which HTLV-1 causes TSP is not fully understood. It is believed that the virus triggers an immune response that leads to inflammation and damage to the spinal cord. This results in the characteristic symptoms of the disease.

Diagnosis

Diagnosis of TSP involves clinical evaluation, magnetic resonance imaging (MRI) of the spinal cord, and laboratory tests to detect HTLV-1 antibodies in the blood or cerebrospinal fluid.

Treatment

There is no cure for TSP, and treatment focuses on managing symptoms. Corticosteroids and other immunosuppressive drugs may be used to reduce inflammation. Physical therapy can help maintain mobility and muscle strength.

Prognosis

The progression of TSP varies among individuals. Some patients experience a slow progression of symptoms, while others may have a more rapid decline. Early diagnosis and management can help improve quality of life.

Epidemiology

TSP is most commonly found in regions where HTLV-1 is endemic, such as parts of Japan, the Caribbean, South America, and Africa. The prevalence of the disease is higher in women than in men.

See also

• Human T-lymphotropic virus 1
• Myelopathy
• Spasticity