Motor and somatosensory evoked potential findings in HTLV-I associated myelopathy

The central motor and sensory conduction times were measured using the motor and somatosensory evoked potentials in 21 patients with HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) to evaluate the functions of the corticospinal tract and posterior column. The control subjects were closely matched for gender, age and height with the patients in the central sensory conduction time (CSCT) and central motor conduction time (CMCT) studies. An abnormal upper limb (UL) CMCT was present in six of 34 limbs (17.6%) while the lower limb (LL) CMCT was abnormal in 31 of 42 limbs (73.8%). No patients had an abnormal UL CSCT while the LL CSCT was abnormal in 10 of 32 limbs (31.3%). The frequency of abnormal LL CMCT was significantly higher than that for an abnormal LL CSCT. The duration of the disease and the disability score did not significantly influence the evoked potential findings. These results indicate that major lesions of the spinal cord in HAM/TSP patients tend to be localized more in the descending corticospinal pathways than in the ascending posterior columns at the thoracic spinal cord level. This finding also closely agrees with the clinico-pathological findings of HAM/TSP.