Tropical spastic paraparesis. A clinical study of 50 patients from Tumaco (Colombia) and review of the worldwide features of the syndrome.

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

Tropical spastic paraparesis. A clinical study of 50 patients from Tumaco (Colombia) and review of the worldwide features of the syndrome.

J Neurol Sci. 1988 Oct;87(1):121-38. Unique Identifier : AIDSLINE MED/89055194
Roman GC; Roman LN; Department of Neurology, Texas Tech University Health Sciences,; Center School of Medicine, Lubbock 79430.

Abstract: Tropical spastic paraparesis (TSP) is a chronic and slowly progressive endemic myelopathy occurring in geographical isolates in the Caribbean, South India, South Africa, the Seychelles, and Colombia. A detailed clinical and laboratory study was performed on 50 TSP patients from the island of Tumaco (Colombia), in a tropical rain forest area. Most patients were middle-aged blacks, 29 (58%) men and 21 women. In every case, neurological examination confirmed the presence of pyramidal signs in the lower limbs, plus, in 58%, moderate decrease in vibratory perception distally in the feet, bilaterally and symmetrically. Absent ankle jerks were found in 28%. Slow onset and chronic progression were documented in most patients. Positive treponemal serology, from yaws infection in childhood, was found in the serum in 92%, and in 19% also in the cerebrospinal fluid (CSF). No pleocytosis was documented on 27 CSF samples, but increased protein content occurred in 86%, with elevation of gamma-globulins in 78%. Treatment of 20 patients with high doses of penicillin produced no change in the clinical picture. TSP emerges from this review of the literature as a remarkably homogeneous clinical entity worldwide. A retrovirus-human T-lymphotropic virus type 1 (HTLV-1)--has been recently implicated as a possible etiology of the syndrome.

Keywords: Adult Aged Colombia Female Human Male Middle Age Paraparesis, Tropical Spastic/*EPIDEMIOLOGY/IMMUNOLOGY/ PHYSIOPATHOLOGY Support, Non-U.S. Gov't Syndrome JOURNAL ARTICLE

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