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Chronic progressive cervical myelopathy with HTLV-I infection: Variant form of HAM/TSP?
F Umehara1, S Nagatomo, K Yoshishige
1Department of Neurology, Graduate School of Kagoshima University, Sakuragaoka 8-35-1, Kagoshima 8900075, Japan. umehara@m2.kufm.kagoshima-u.ac.jp
Objective:
To investigate the role of human T-lymphotrophic virus type I (HTLV-I) infection in four patients who developed slowly progressive myelopathy with abnormal MRI lesions in the cervical cord levels.
Methods:
Clinical and neuroradiologic examinations were performed, and the odds that an HTLV-I-infected individual of specified genotype, age, and provirus load had HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP) were calculated.
Results:
Anti-HTLV-I antibodies were positive in both the serum and the CSF in all of the patients. Biopsied sample from spinal cord lesions showed inflammatory changes in Patient 1. Patient 2 had a demyelinating type of sensorimotor polyneuropathy. Two of the three patients examined showed high risk of developing HAM/TSP in virologic and immunologic aspects.
Conclusion:
These four cases may belong to a variant form of HAM/TSP, predominantly involving the cervical cord levels.
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