Leon-Sarmiento Fidias E, Calderon Andres, Hernandez Hernan G
Unit of Movement Disorders and Neuromagnetismo, Neurology Section, Fundacion Santa Fe, Bogota, Colombia.
Arq Neuropsiquiatr. 2008 Sep;66(3B):695-7. doi: 10.1590/s0004-282x2008000500016.
Tropical spastic paraparesis (TSP) may or may not be associated to HTLV-I antibodies and is usually characterized by clinical and pathological spinal cord abnormalities at thoracic levels. We present here five Brazilian patients who had typical chronic idiopathic spastic paraparesis; two of them were HTLV-I seropositive (HAM) and three HTLV-I seronegative (TSP) -associated-myelopathy. Three out of these five patients also displayed clinical supraspinal involvement, indeed, platysma muscle hypotrophy or atrophy (the Babinski plus sign). These findings support the view that clinical involvement in HAM and TSP is wider than the spinal cord abnormalities usually considered. Possible non-infectious co-factors (e.g., mycotoxins) may be involved in disease pathogenesis in a multistep process of viruses, toxins and environment which may account for serological differences found in this group of patients.
热带痉挛性截瘫（TSP）可能与人类嗜T淋巴细胞病毒I型（HTLV-I）抗体有关，也可能无关，其通常表现为胸段脊髓的临床和病理异常。我们在此报告五例患有典型慢性特发性痉挛性截瘫的巴西患者；其中两例为HTLV-I血清阳性（HAM），三例为HTLV-I血清阴性（TSP）相关脊髓病。这五例患者中有三例还表现出临床性脊髓上受累，确实存在颈阔肌肌肉张力减退或萎缩（巴宾斯基征阳性）。这些发现支持这样一种观点，即HAM和TSP的临床受累范围比通常认为的脊髓异常更广泛。在病毒、毒素和环境的多步骤过程中，可能的非感染性辅助因素（如霉菌毒素）可能参与疾病发病机制，这可能解释了该组患者中发现的血清学差异。
