Disease Information for Tropical spastic paraparesis

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Clinical Manifestations
Signs & Symptoms
Hypertonia
Weakness, legs, bilateral
Ankle reflexes increased
Ataxia is worse at night
Babinski's upgoing toes/bilateral
Equinus Posture/Ankles
Hyperreflexia/DTRs increased
Involuntary Leg Movement Standing
Knee reflexes increased
Legs increased tone/spastic/hyperreflexic
Paralysis
Position sense decreased/proprioception
Position sense decreased/proprioception Legs
Spasms in Both Legs
Spastic paraplegia/signs
Spasticity/Spastic gait
Spinal cord level lesion/signs
Unable to walk
Vibratory sense decreased
Vibratory sense decreased Legs
Urine Incontinence
Disease Progression
Course/Acute
Course/Chronic disorder
Course/Progressive
Course/Subacute
Demographics & Risk Factors
Travel, Geographic & Climate Related Factors
Residence/travel/Africa
Residence/travel/Caribbean
Residence/travel/Columbia
Residence/travel/India
Residence/travel/Japan
Past History
Past history/Intravenous drug user
Recent Event
Recent/Travel
Population Group
Population/Immigrant population
Laboratory Tests
Microbiology & Serology Findings
Microlab/HTLV-2 virus isolate
Abnormal Lab Findings (Non Measured)
Right Shift (Viral) Differential Smear (Lab)
Diagnostic Test Results
Pathology
PATH/Spinal cord necrosis/lesions
CT Scan
MRI/Spinal cord abnormalities
Associated Diseases & Rule outs
Rule Outs
Amyotrophic lateral sclerosis
Lathyrism/legume toxicity
Multiple sclerosis
Associated Disease & Complications
Arthritis
Paraparesis
Paraplegia
Posterior column disease/cord
Spinal cord lesion/dysfunction
T-cell leukemia
T-cell lymphoma
Tropical Spastic Paraparesis
Uveitis
Xerophthalmia
Demyelinating Disease
Disease Mechanism & Classification
Specific Agent
AGENT/Blood transfusion/potential spread (ex)
AGENT/Community disease/endemic
AGENT/Disease transmitted sexually/potential
AGENT/Endemic disease (ex)
AGENT/Lymphotropic virus
AGENT/Tropical infections/diseases
AGENT/Virus (category)
Microlab/HLTV1 (Lymphotropic virus, human I) Present
Class
CLASS/Neurologic (category)
CLASS/Spinal cord disorder (ex)
Pathophysiology
Pathophysiology/HLTVI (Lymphotropic virus, human I)
Pathophysiology/Demyelination
Process
PROCESS/INCIDENCE/Regional specific
PROCESS/Infected organ/abscess (category)
PROCESS/Infection/agent specific (category)
Toxin
TOXIN/Poisonous Plant (ex)
Synonyms
Synonym
FAMILIAL SPASTIC PARAPARESIS HTLV 1 ASSOCIATED, HAM, HAM HTLV 1 associated myelopathy, HAM HTLV 1 associat myelopathy, HTLV 1 associated myelopathy, HTLV 1 associated myelopathy tropical spastic paraparesis, HTLV 1 associated myelopathy tropical spastic paraparesis (disorder), HTLV I ASSOC MYELOPATHIES, HTLV I ASSOC MYELOPATHY, HTLV I ASSOC MYELOPATHY TROPICAL SPASTIC PARAPARESIS, HTLV I Associated Myelopathies, HTLV I Associated Myelopathy, HTLV I Associated Myelopathy Tropical Spastic Paraparesis, HTLV WI ASSOCIATED MYELOPATHY, Human T cell leukaemia virus type I myelopathy, Human T cell leukemia virus type I myelopathy, Human T cell lymphotropic virus (HTLV) 1 associated myelopathy tropical spastic paraparesis, Human T cell lymphotropic virus (HTLV) 1 associated myelopathy tropical spastic paraparesis (disorder), HUMAN T LYMPHOTROPIC VIRUS TYPE 1 ASSOC MYELOPATHY, Human T Lymphotropic Virus Type 1 Associated Myelopathy, Jamaican (tropical) myeloneuropathy, Jamaican neuropathy, Jamaican syndrome, MYELOPATHIES HTLV I ASSOC, Myelopathies HTLV I Associated, MYELOPATHY HTLV 1 ASSOCIATED, Myelopathy HTLV I Associated, MYELOPATHY HUMAN T LYMPHOTROPIC VIRUS TYPE 1 ASSOC, Myelopathy Human T Lymphotropic Virus Type 1 Associated, Parapareses Tropical Spastic, Paraparesis Tropical Spastic, paraplegia spastic tropical, paraplegia tropical spastic, Paraplegias Tropical Spastic, Spastic Parapareses Tropical, Spastic Paraparesis Tropical, spastic paraplegia tropical, Spastic Paraplegias Tropical, tropical paraplegia spastic, Tropical spastic paralysis, Tropical Spastic Parapareses, tropical spastic paraparesis, Tropical Spastic Paraplegia, Tropical Spastic Paraplegias, Tropical spastic paresis, TSP Trop spastic paraparesis, TSP Tropical spastic paraparesis, Synonym/HAM-TSP (Paraparesis), Synonym/HLTV-1 associated Myelopathy (HAM)
Treatment
Drug Therapy - Indication
RX/Muscle relaxant medication
Definition

A subacute paralytic myeloneuropathy occurring endemically in tropical areas such as the Caribbean, Colombia, India, and Africa, as well as in the southwestern region of Japan; associated with infection by human T-cell leukemia virus type I (HUMAN T-LYMPHOTROPIC VIRUS 1); Clinical manifestations include a slowly progressive spastic weakness of the legs, increased reflexes, Babinski signs, incontinence, and loss of vibratory and position sensation; On pathologic examination inflammatory, demyelination, and necrotic lesions may be found in the spinal cord-----(Adams et al, Principles of Neurology, 6th ed, p1239)-----------

For several decades the term “tropical spastic paraparesis” (TSP) has been used to describe a chronic and progressive disease of the nervous system that affects adults living in equatorial areas of the world and causes progressive weakness, stiff muscles, muscle spasms, sensory disturbance, and sphincter dysfunction; The cause of TSP was obscure until the mid-1980s, when an important association was established between the human retrovirus — human T-cell lymphotrophic virus type 1 (also known as HTLV-1) — and TSP; TSP is now called HTLV-1 associated myelopathy/ tropical spastic paraparesis or HAM/TSP; The HTLV-1 retrovirus is thought to cause at least 80 percent of the cases of HAM/TSP by impairing the immune system; In addition to neurological symptoms of weakness and muscle stiffness or spasms, in rare cases individuals with HAM/TSP also exhibit uveitis (inflammation of the uveal tract of the eye), arthritis (inflammation of one or more joints), pulmonary lymphocytic alveolitis (inflammation of the lung), polymyositis (an inflammatory muscle disease), keratoconjunctivitis sicca (persistent dryness of the cornea and conjunctiva), and infectious dermatitis (inflammation of the skin); The other serious complication of HTLV-1 infection is the development of adult T-cell leukemia or lymphoma; Nervous system and blood-related complications occur only in a very small proportion of infected individuals, while most remain largely without symptoms throughout their lives; The HTLV-1 virus is transmitted person-to-person via infected cells: breast-feeding by mothers who are seropositive (in other words, have high levels of virus antibodies in their blood), sharing infected needles during intravenous drug use, or having sexual relations with a seropositive partner; Less than 2 percent of HTLV-1 seropositive carriers will become HAM/TSP patients; There is no established treatment program for HAM/TSP; Corticosteroids may relieve some symptoms, but aren’t likely to change the course of the disorder; Clinical studies suggest that interferon alpha provides benefits over short periods and some aspects of disease activity may be improved favorably using interferon beta; Stiff and spastic muscles may be treated with lioresal or tizanidine. Urinary dysfunction may be treated with oxybutynin; HAM/TSP is a progressive disease, but it is rarely fatal; Most individuals live for several decades after the diagnosis; Their prognosis improves if they take steps to prevent urinary tract infection and skin sores, and if they participate in physical and occupational therapy programs --------------------------[NINDS/NIH]---------------------

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