Tropical spastic paraparesis

Tropical spastic paraparesis (TSP), also known as HTLV-1 associated myelopathy (HAM), is a medical condition that causes progressive weakness and stiffness of the legs. It is associated with infection by the Human T-lymphotropic virus 1 (HTLV-1).

Etiology

TSP is caused by the HTLV-1, a retrovirus that is spread through sexual contact, blood transfusion, and from mother to child during breastfeeding. The virus infects the T cells of the immune system, leading to inflammation and damage to the spinal cord.

Symptoms

The main symptoms of TSP are progressive weakness and stiffness of the legs. Other symptoms may include lower back pain, urinary incontinence, and erectile dysfunction in men. In some cases, patients may also experience sensory disturbances such as numbness or tingling in the legs.

Diagnosis

The diagnosis of TSP is based on clinical symptoms, a history of exposure to HTLV-1, and the exclusion of other causes of myelopathy. Magnetic resonance imaging (MRI) of the spinal cord may show atrophy or other changes suggestive of TSP. Blood tests can confirm the presence of HTLV-1 infection.

Treatment

There is no cure for TSP, but treatment can help manage symptoms. This may include physical therapy to improve mobility and strength, medications to manage pain and spasticity, and interventions to manage bladder and bowel dysfunction.

Epidemiology

TSP is most common in areas where HTLV-1 is endemic, such as the Caribbean, parts of Africa, and Japan. It is estimated that up to 5% of people infected with HTLV-1 will develop TSP.

See also

• Human T-lymphotropic virus
• Spastic paraparesis
• Myelopathy

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