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MRI-pathological correlate of brain lesions in a necropsy case of HTLV-I associated myelopathy
A Ogata1, K Nagashima, K Tashiro
1Department of Neurology, Hokkaido University School of Medicine, Sapporo, Japan.
Abstract:
A postmortem case of HTLV-I associated myelopathy (HAM)/tropical spastic paraparesis (TSP) with a history of remission and exacerbation of neurological signs and symptoms, resembling those of multiple sclerosis is reported. MRI analysis revealed lesions in the periventricular white matter in addition to atrophy of the thoracic spinal cord, characteristic of HAM/TSP. The cerebral periventricular areas consisted of ill-defined paucity of myelin sheaths with astrocytic gliosis and hyaline thickening of blood vessels. The poorly demarcated white matter lesions found in both brain and spinal cord were different from plaques found in multiple sclerosis. It is suggested that, in some cases of HAM/TSP, inflammatory lesions that destroy myelin can involve not only the spinal cord but also the cerebral periventricular white matter.
Insights
This case study reports a patient with Human T-lymphotropic virus type I (HTLV-I) associated myelopathy (HAM)/tropical spastic paraparesis (TSP) exhibiting neurological symptoms similar to multiple sclerosis. Postmortem MRI revealed characteristic spinal cord atrophy and cerebral white matter lesions, suggesting broader inflammatory involvement in HAM/TSP.
Area of Science:
- Neurology
- Neuroimmunology
- Pathology
Background:
- Human T-lymphotropic virus type I (HTLV-I) associated myelopathy (HAM)/tropical spastic paraparesis (TSP) is a chronic inflammatory neurological disease.
- HAM/TSP symptoms can mimic other neurological conditions, including multiple sclerosis (MS).
- Understanding the neuropathological features of HAM/TSP is crucial for accurate diagnosis and management.