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NEUROLOGY 2004;63:1276-1280
© 2004 American Academy of Neurology

Chronic progressive cervical myelopathy with HTLV-I infection

Variant form of HAM/TSP?

F. Umehara, MD, S. Nagatomo, MD, K. Yoshishige, MD, M. Saito, MD, Y. Furukawa, MD, K. Usuku, MD and M. Osame, MD

From the Departments of Neurology and Geriatrics (Drs. Umehara, Nagatomo, Yoshishige, Saito, and Osame), Division of Blood Transfusion Medicine (Dr. Furukawa), and Department of Medical Information Science (Dr. Usuku), Graduate School of Kagoshima University, Japan.

Address correspondence and reprint requests to Dr. F. Umehara, Department of Neurology, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima 8900075, Japan; e-mail: umehara{at}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.

Received February 13, 2004. Accepted in final form June 1, 2004.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 12 issue to find the title link for this article.




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