Tropical spastic paraparesis

A disease caused by the human T-lymphotropic virus 1

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.

Related pages

• Human T-lymphotropic virus 1
• Myelopathy
• Spasticity

Images

Electron micrograph of HTLV-1

Histopathological image of muscle tissue

Diagram of an immunoglobulin molecule

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  Electron micrograph of HTLV-1 virus particles

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  Histological section showing polymyositis

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  Diagram of an immunoglobulin molecule